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Interested in putting Second Step to work for your students? Attend one of our sessions listed below to hear directly from our experts.

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School counseling at the elementary school level during a pandemic, or at other times when virtual school counseling is required, may seem more manageable when viewed through the domains of school counseling. Unlike school counseling for middle or high school students, counseling elementary school students requires more hands-on work by families. Learn about various ways to provide Tier 1 counseling services virtually without overwhelming parents/guardians, students or yourself. Download handout here.
Earn 0.1 CEUs/1 contact hours for this webinar by purchasing and passing the corresponding quiz found in the Specialists and Exams section of the Online Store. Search on the webinar title to find the exam in the online store. CEU exams are available for three years following the live webinar. Learning objectives:
After viewing this webinar you should be able to:

1. Discuss best practices when working with elementary students and families in a virtual setting.

2. Identify various technology tools and resources to aid you in your virtual elementary counseling.

3. Describe at least one lesson you can use when counseling your elementary students.

Presenter:
Sarah Kirk, Elementary School Counselor, Kendall-Whittier Elementary School, Tulsa, Okla.
Original air date: April 16, 2020

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Virtual Elementary School Counseling: Tier 1 How-to

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School counseling at the elementary school level during a pandemic, or at other times when virtual school counseling is required, may seem more manageable when viewed through the domains of school counseling. Unlike school counseling for middle or high school students, counseling elementary school students requires more hands-on work by families.

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As we all do our own versions of the counselor COVID pivot, certain students and families are taking up a lot of space in our minds. Many of us are extra worried these days about our students who have experienced trauma, so let's explore helpful information and resources on trauma-informed virtual school counseling.

Trauma-Informed Virtual School Counseling: Background Information

One of the best sources on information related to how our students and families are faring in this pandemic world comes from a webinar provided by Dr. Bessel van der Kolk, one of the world's leading trauma experts. He points out that we are in a in a pre-traumatic stage and that there are actually 3 issues that families are grappling with in this very unsettling new normal:

He goes on to explain that there are no experts in this field of a current-day pandemic, so we are all stumbling through this experience, and the trauma of it, together. He also notes that domestic violence sharply increased in Spain, Italy, and China in the last few months, so we expect to see the same here in the USA. This leads us to the necessity of dicussing our topic today- how to support our tramatized students through virtual school counseling.

(Van der Kolk, 2020)

In addition to Dr. van der Kolk's webinar, here are a few informative articles to give you a fuller picture of what our traumatized kids and fams are facing during the pandemic:

"Children More at Risk for Abuse and Neglect Amid Coronavirus Pandemic" by Suzanne Hirt, Andrea Ball and Katie Wedell

"Coronavirus Roils Every Segment of US Child Welfare System" by David Crary

"COVID-19 Fact Sheet for Grandfamilies and Multigenerational Families" by Generation United

Trauma-Informed Virtual School Counseling: Strategies & Activities

When this pandemic first hit, I started combing through all the news and literature to find strategies and activities on supporting traumatized students through online platforms. All of the ideas I detail below can be tweaked to use in individual, group, or lesson settings. If you need more info on the basics of how to run trauma-informed guidance lessons, groups, or individual sessions, check out this post I wrote in 2018.

When No One Shows Up

Keep in mind that it can be very hard to connect with students during this time. Everyone is overwhelmed with technology and kids will be kids. After all, the alternative to working with their teacher or school counselor might be a video game or Youtube show! And this is especially true for our kiddos that are not supervised during the day because their parents are working. So, go easy on yourself if you are having trouble reaching students. Consider it a huge success if you make a few student connections a day or a week! In order to make any progress, it may very well be that you have to choose the 5-20 highest student concerns on your list and then chase them down through phone calls, etc. This is normal and you are doing amazing work at trying to maintain those connections.

Strategies

Ok, a few trauma-informed strategies activities for when you do make contact...

Connect your students to each other with games, virtual storytelling hours, and music.

Lead students through breathwork and grounding activities; make sure to spend time processing how they felt during the activity. You can find many of these types of relaxation and self-regulation activities here in my:

Encourage students to talk through their emotional state with others by modeling this for the whole family.

Teach students body-calming techniques such as yoga and tai chi. These will help students to self-regulate and avoid negative alternatives to upsetting physiological reactions, such as alcohol or drug use (Van der Kolk, 2020).

I've discussed and shared videos previously about my Counselor Corner that I run, so how about transitioning to a virtual Counselor Corner (CC) now?!? If you are new to the idea of CC, here's quick explanation. Head to the cafeteria one day a week to sit through all student lunch periods. This gives kids a chance to to talk with you about anything that's on their mind. I take my CC sign, request forms, and pencils so students can sign up to talk to me more privately later on in the day, if necessary. In the cafeteria, I sit at a round table that is placed off to the side. I remind students on the microphone that I'm available during their lunch. To reduce the stigma, I tell them I'm there for anyone to come talk, say hi, or check their grades. Some days I'm really busy and some days I'm not. So, I bring my laptop and work on my paperwork tasks if I have downtime there. Now a virtual CC could work in much the same way: you would designate a time and online platform link for CC. Then, on the CC day, just eat your lunch at your computer in a video chat platform such as Zoom or Google Hangout Meets. Wait for students to jump on and join you. You could also have a topic or story or mindful activity that you faciliate with students as well. You might even consider offering a door prize of college swag (mail it to them) to the first 5 or 10 students that come by to say hi at your virtual CC!

Trauma-Informed Virtual School Counseling: Resources

ChildTrends has the best resource I've come across for working with students of trauma during the pandemic. Many different tips are given here such as:

Guiding students to identify/seek out thepresence of a responsive caregiver.

Reaching out to your most pressing student concerns. Brainstorm with them on how to connect with friends/family because "social distancing should not mean social isolation" (Childmind.org, 2020).

Practicing the 3 Rs with students: Reassurance, Routines, and Regulation. You could implement the 3 Rs using resources at these links: virtual guidance lessons, minute meeting checkins, and even some trauma-informed group sessions, if possible.

Here is an amazing toolkit for parents from the Center for Youth Wellness.

This article from ChildMind gives fantastic ideas on how to meet kids' SEL needs at this time.

Here is a list of helpful apps curated by Edweek.org:

The SuperBetter app teaches SEL skills to students.

The Calm app, which we all know, now has activities just for kids.

The new Atlas app has podcasts with student stories on stress and life.

GoogleDuo provides a way to do virtual counseling with 3-5 year olds from families with a history of trauma.

Online check-ins can be used for your Minute Meetings and more!

Trauma-Informed Virtual School Counseling: Protecting Students

So, what can we do for the rest of our students? How do we support the ones who have never experienced trauma before the pandemic, but sure are being traumatized right now by COVID? Well, Dr. Bruce Perry to the rescue! His webinar had some of the best ideas that I've come across related to trauma and the coronavirus. I'm just going to quote him, because no one says it better...

"Decrease your and your students' typical workload. Activation of the body's stress response systems requires emotional and physical energy. A key consequence of prolonged stress is exhaustion. Expect more fatigues, expect everyone to be less capable of focus, epect more irritability from yourself and others. Be gentle with yourself and others" (Perry, 2020).

And finally, two more fab info sheets here on how to protect and support kids from pandemic trauma:

(NCTSN, 2020)

That brings me to the end of this May post on trauma. Please leave a comment- I'd love to hear about how you infuse trauma-informed strategies into your virtual counseling program. Catch up with me again in June for my monthly counseling post that I share during the first weekend of every month!

In the meantime, you can find out about my latest promotions, free stuff, or counseling adventures by following me on my School Counselor Stephanie Instagram, Facebook, or Pinterest pages!

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Trauma-Informed Virtual School Counseling - School Counselor Stephanie

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As we all do our own versions of the counselor COVID pivot, certain students and families are taking up a lot of space in our minds. Many of us are extra worried these days about our students who have experienced trauma, so let's explore helpful information and resources on trauma-informed virtual school counseling.

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It's a Thursday afternoon and I'm meeting on Zoom with Yafae and Elijah, two Chicago high school sophomores, and their teacher Melissa Hughes-all of us at home due to coronavirus mandates.

While teachers and parents around the country fret about the transition to home-based learning during the pandemic, the boys say that's not what they're worried about. They're thinking about the other impacts of being home-namely the loss of connections, experiences, and memories made at school.

"Some people really rely on other people to make them happy. They get joy coming to school and seeing their friends," said Yafae, who tells me he hasn't gone outside since the weekend but is itching to go for a run to stay in shape for football. "A lot of my peers are scared," adds Elijah. "We can't really do anything. We can't go places... There's just a lot of stuff going on in my head."

It was only a few weeks ago that the boys and their peers were notified that their school, like schools across the nation, was closing its doors. As teachers and students hastily prepared for the transition, the boys did their own scrambling-to record a series of podcasts about the stress and uncertainty many kids were experiencing. On one episode, a social worker talks young listeners through mindful breathing exercises to calm the brain; on another, a counselor reminds students "an idle mind is the devil's playground," and encourages them to brainstorm activities like playing video games, doing pushups, and reading books to cope with being home.
Courtesy of Charles Anderson
The boys' novel response to the circumstances-a mix of new technologies and more traditional counseling known as "telehealth" or "teletherapy"-is now being adopted in a hurry by school districts around the country. Seeking new avenues to reach kids without direct access to school-based services, counselors and social workers are now connecting via video conference, apps, and phone calls, or working directly with teachers to embed social and emotional practices into their remote teaching.

Counselors, principals, and teachers share their new approaches:

The Big Privacy Question

Regulations around the privacy of minors-who had limited telehealth offerings in schools in the past-are being loosened during the pandemic, allowing districts to offer virtual counseling and therapy sessions for students who need it, according to Debbie Plotnick, a vice president at Mental Health America, who says it may set a new precedent for school-based health care.

Students who were already receiving services at school can continue one-to-one sessions (or even group therapy) by video or phone. Some districts, such as Onslow County Schools in North Carolina and Seattle Public Schools, are also providing the option for any student who feels they need to talk. For counselors or psychologists who are new to running virtual therapy sessions, national organizations like the National Center for School Mental Health and the American School Counselors Association are offering resource pages and videos with guidelines.

Given the legal implications, educators recommend being fully transparent about the risks of virtual settings, and asking families to provide explicit consent for virtual counseling. In the San Carlos, California, school district, for example, an email was sent out to parents of children receiving counseling services notifying them that absolute privacy cannot be guaranteed using telecommunications platforms, and getting confirmation they were comfortable with it.

There's an App for That

Educators are also turning to a wide array of digital tools that provide everything from breathing exercises and journaling prompts to quick options to check on a students' mental health. Alex Shevrin Venet, a college professor and former administrator at a therapeutic high school, recommends the SuperBetter app, which uses digital games like "fulfilling a quest" or "recruiting allies" to teach kids social and emotional skills like cooperation and persistence. The popular Calm app, which focuses on relaxation, also features activities just for kids.

Designed with help from high school students, the new Atlas app offers users a library of podcasts-updated weekly-featuring students' own stories on stress and ruminations on their lives. The reflections are paired with "techniques and strategies that you would find in evidence-based therapies to help students work through whatever they're going through," said Max Savage, one of the co-founders, who is now offering the app for free during coronavirus school closures. Forty-two schools are currently partnered with Atlas.

Apps can even serve very young learners. A pre-k program in Ohio recently tested out GoogleDuo -a video communications app with stringent privacy standards-to conduct virtual counseling with 3-5 year olds from families with a history of trauma. Though the children struggled a bit to sit still and adapt to the medium, the educators worked through the problems. "There's nothing that's going to substitute" for face-to-face counseling, said one mental health counselor, but the program is now considering using the app for summer extensions after the pandemic ends.

Embedding Virtual Touchpoints

Regular touchpoints like online check-ins can also help ensure kids are tethered to the school community and aren't slipping through the cracks, say educators and counselors we talked to.

Sarahi Monterrey, the 2018-2019 Wisconsin State Teacher of the Year, says she's started asking students how they are feeling in her daily Google attendance form as a way to keep tabs on students' mental health, for example. Other teachers suggest monitoring attendance in digital classrooms carefully, then notifying counselors if a student is chronically absent or unengaged in activities so they can reach out directly.

Meanwhile, Phyllis Fagell, a school counselor in Washington, D.C., recommends teachers and counselors carve out time to have students do non-academic activities online together like play games and participate in book clubs, lunch groups, or small group projects to give them moments of "joy and relief" with their peers.

It's also important for counselors and educators to connect with parents/caregivers to understand the best ways to reach them and to get a sense of what's going on at home, says Mathew Portell, a principal of a Title I elementary school in Nashville, Tennessee, who has made it a priority to call all 325 families at his school during the closure.

"What we're learning right now is that the majority of our parents are in survival mode; they need comfort and somebody they trust and talk to," said Portell, who plans to continue the practice into next school year.

Always-On Portals

Online portals stocked with social and emotional resources can be a rich, asynchronous destination for parents and teachers to support students' mental health on their own time.

In the San Carlos school district, counselors set up an online portal that provides weekly social and emotional learning (SEL) activities teachers or parents can use on topics like emotion regulation and calming/breathing routines. Similarly, Sarah Kirk, an elementary school counselor in Oklahoma, has set up a page on her class website dedicated to the coronavirus that provides a list of SEL resources for families and teachers, such as books about identifying feelings, games that teach self-regulation skills, and reflective activities to do while watching TV or movies.

Community Partners

Some districts recommend working collaboratively with health care providers in their communities to extend their reach to more students.

A number of providers, who already have experience with telehealth, are offering pro bono or heavily discounted costs for virtual counseling services during this time, according to educators. In New York City, for example, 60 community agencies are now partnering with local schools to support students' mental health, while in San Carlos, California, schools are working directly with the local One Life Counseling Center, which offers reduced-cost and free services for families in need.

A Note of Caution

Mental health professionals urge caution with all digital outreach, given that not all families have the resources to stay tapped in virtually, and recommend educators consider ways they can reach everyone-whether it be by phone, text messages, or even letters sent home.

Additionally, while mental health professionals encourage schools to address students' and families' immediate needs, they are mindful they may face challenging issues ahead-like a family's changing circumstances, and loss of jobs or even lives-that will have significant impacts on students as they transition back to school.

But though the pending issues are grave, mental health professionals retain some optimism that the digitals tools will provide new ways to connect with and support students now-and when the pandemic ends. "We've got to see the silver lining in all of this," said Melissa Reeves, past president of the National Association for School Psychologists. "It's a new skill set that might enable us to increase and provide services in ways we haven't in the past to reach more students."

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There's an App for That-School Counseling and SEL Go Online

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It's a Thursday afternoon and I'm meeting on Zoom with Yafae and Elijah, two Chicago high school sophomores, and their teacher Melissa Hughes-all of us at home due to coronavirus mandates. While teachers and parents around the country fret about the transition to home-based learning during the pandemic, the boys say that's not what they're worried about.

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The Nebraska School Counselor Association is prepared to support Nebraska School Counselors through these unprecedented times and the uncharted territory that school counselors and schools in general face. We plan to lead the coming together of school counselors from across Nebraska to share ideas and work together to ease the burden that the COVID-19 places on school counselors. Below you will find multiple resources for school counselors including documents from the American School Counselor Association (ASCA), information on virtual counseling practices, information for schools regarding COVID-19, and resources for school counselors as we look forward to re-opening schools. This webpage will be continually updated as information changes and as we find additional resources.

NSCA wants to hear from you as to what you need during this time and we will do what we can to support you. E-mail your needs or suggestions to Doug Hauserman at executivedirector@neschoolcounselor.org. Also, if you come across a great resource you think we should share on our website, please send that to Doug Hauserman as well.

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The Nebraska School Counselor Association is prepared to support Nebraska School Counselors through these unprecedented times and the uncharted territory that school counselors and schools in general face. We plan to lead the coming together of school counselors from across Nebraska to share ideas and work together to ease the burden that the COVID-19 places on school counselors.

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Find the solution to all your planning nightmares! This article houses my complete School Counseling Lessons with my yearly outline and examples along the way! Believe me.... you don't want to miss out!
This article may use affiliate links. Which simply means, if you click on a link in this post, I may or may not get paid for sharing the resource with you. You can find more information on my Privacy Page and Disclosure.
So... planning the entire school counseling year can be stressful! Most take it a piece at a time. I get that... but I like to have all my standards planned and organized so I know what I am preparing for each month. It makes life so much easier... if I know my plan ahead of time!

With that being said... I am going to list out the activities and resources I use during my school counseling lessons each month.

So, first of all, we talk a lot about the 7 Habits of Happy Kids at our school. We really focus on leadership and letting students take responsibility for their learning. I do school counseling lessons every month on the 7 Habits. I will list what I use for that below...

Teaching the 7 Habits of Happy Kids (Sept. - May)

August (Meet Your School Counselor)

September (Skills Needed for Educational Achievement/Expected Vs. Unexpected Behaviors)

October (Personal Safety/Drug Awareness)

SCOOP by: Julia Cook

Scoop Activity Flipbook

Charlie and the Curious Club Candy or Medicine by: Erianna Winnett

I Said NO! by: Zack + Kimberly King

No Thanks! Saying No to Drugs and Alcohol by: Erianna Winnett

Berenstain Bears Learn about Strangers by: Stan and Jan Berenstain

What if a Stranger Approaches You? by: Anara Guard

Smoking Stinks by: Kim Gosselin

Not Everyone is Nice by: Frederick Almonti and Ann Tedesco, PhD.

Red Ribbon Week Bundle

November (College & Career Readiness)

December (Friendship Skills)

January (Conflict Resolution)

How to be a Friend by: Laurie Krasny

You're Mean Lilly Jean by: Frieda Wishinsky

Do Unto Otters by: Laurie Keller

Cliques Just Don't Make Cents by: Julia Cook

Peace Path A Conflict Resolution Guide for Kids (we go outside and practice using this)

Bullies are a Pain in the Brain (DVD) by: Trevor Romain

Broken Toy (DVD) by: National Center for Youth Issues (Grades 4 and up)

Gum In My Hair, How to Cope with Bullying Version 2.0 (DVD) by: Twisted Scholar (MY FAVORITE)

February (Feelings/Emotions)

March (Stress Reduction + Coping Skills)

April (Testing Preparation)

May (Transitions)

I hope this bibliography and activity list can help you plan out your year! If you have a Type A personality like myself (ha,ha), I have included my personal Yearly Lesson Outline below! Click on the link or the picture to see the full outline.

Let me know the resources you use throughout the year? How do you plan and organize your school counseling lessons?

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Cheat Sheet for School Counseling Lessons

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Find the solution to all your planning nightmares! This article houses my complete School Counseling Lessons with my yearly outline and examples along the way! Believe me.... you don't want to miss out! This article may use affiliate links.

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DropCatch.com helps you secure expiring domain names.

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FLYER When to Refer a Student for MH Assistance

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PBISWorld Tier 2 interventions are more targeted and individualized behavior strategies. Counselor Referrals are a great way to direct students toward more intensive supports. Counselors are able to more specifically and directly address behaviors than the classroom instructor.

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There are fewer more frightening or challenging psychiatric conditions for a family to face than psychosis, an extreme mental state in which impaired thinking and emotions cause a person to lose contact with reality. This could mean hearing or seeing things that aren't there (hallucinations), or believing things that aren't true (delusions).

The illness most often associated with psychosis, schizophrenia, usually doesn't show up until very late adolescence or early adulthood. Recently, however, experts in the field have been working to identify high-risk kids who show symptoms that could serve as early warning signs of psychosis, and several academic centers have been set up to focus on this crucial period when it may be possible to change the trajectory of mental illness.

Not all the kids who are identified with what experts call "prodromal" symptoms will progress, or "convert" to full-blown psychotic illness. But early intervention has been shown to improve outcomes for those who do. And since psychotic symptoms cause disruption across a teenager's life, from school to friendships to family, researchers are hoping quick action can prevent impairment and prolong typical functioning.

What's more, some of the approaches that show promise in delaying onset of psychosis or mitigating symptoms include fairly simple lifestyle changes like stress reduction and sleep hygiene, and managing co-occurring disorders like anxiety. The key: identifying at-risk kids earlier when these low-impact measures are still effective.

What are "prodromal" symptoms?

Prodromal symptoms are "attenuated" or weak symptoms of psychosis. Moreover, "they are a warning sign," says Dr. Christoph Correll, the medical director of the Recognition and Prevention Program (RAP) at Zucker Hillside Hospital in Queens, NY, which specializes in diagnosing and treating early symptoms of mental illness in teenagers and young adults. "These signs can happen in people who don't go on to develop psychosis-but if we follow these people who are in the risk state based on these watered-down versions, one third will probably go on to develop psychosis. That's a lot more than in the general population."

Prodromal symptoms occur on a spectrum from very, very mild to severe and can include:

Withdrawing from friends and family/feeling suspicious of others

Changes in sleeping or eating patterns

Less concern with appearance, clothes or hygiene

Difficulty organizing thoughts or speech

Loss of usual interest in activities or of motivation and energy

Development of unusual ideas or behaviors

Unusual perceptions, such as visions or hearing voices (or even seeing shadows)

Feeling like things are unreal

Change in personality

Feelings of grandiosity (belief he has a superpower, etc)

In some cases, these symptoms represent the early stages of a disorder, and will eventually convert. In others, the symptoms actually fade or remain mild. Dr. Tiziano Colibazzi is a psychiatrist at Columbia Presbyterian's COPE clinic (Center for Prevention and Evaluation), which was established to research and treat prodromal symptoms. "We can identify a group of people that are at clinically high risk," says Dr. Colibazzi. "What we can't do is narrow that group down further to identify the 30 percent who will convert."

First step if you feel your child is at risk: An evaluation

The right treatment for prodromal symptoms depends entirely on how severe they are when they are diagnosed. The first step is a proper and complete diagnosis by a mental health professional with experience in assessing psychotic illness.

If you see marked changes in motivation, thinking, and/or behavior in your child, the first place to start is with her pediatrician to rule out a medical illness. Substance use also needs to be ruled out as the cause of any behavior changes in adolescents. After that, you're going to want to have your child evaluated by a qualified psychiatrist or psychologist. This in itself might be a multi-step process.

"You can't just look at the kid once and get a bit of a history and then know what's going on, " says Dr. Correll. "Kids develop; symptoms develop. And the trajectory-how things change, get better or worse, what other symptoms add on to it-will be highly informative in telling us something about the prognosis, what we expect to happen."

One aid to predicting the evolution and severity of symptoms, notes Dr. Colibazzi, is the patient's ability to doubt his symptoms. If your child retains the self-awareness to know that it's his mind that is playing tricks on him, it's an indication that symptoms are still in the very early stages. As symptoms become more severe, the patient's beliefs (whether paranoid, grandiose or hallucinatory) become increasingly difficult to challenge.

Lifestyle and mental health options

Psychotic symptoms and illnesses have been shown to vary quite a bit depending on the environment-the health of our bodies, our interpersonal relationships, our mindsets. As with any illness, but particularly important in at-risk youth, healthy living is key. Regardless of the severity of prodromal symptoms, Dr. Correll says that your child's outcome can be improved by making sure your kid sticks to a routine that includes:

Eating well

Getting regular exercise

Adhering to a regular sleep schedule

Reducing stress as much as possible

Staying away from drugs-particularly marijuana, which can interact with prodromal symptoms and increase the risk for psychosis significantly

Also, don't forget to address depression and anxiety. According to Dr. Correll, "adults who eventually developed schizophrenia identified a three to five year period during which they experienced depression or anxiety before developing the prodromal symptoms of psychosis and then developed full-blown psychosis." "So treating the depression early," he says, "might actually interrupt the progression from depression to psychosis in some patients."

Treatment for prodromal psychotic symptoms

Dr. Correll recommends trying several approaches. Mild symptoms call for more low-key treatments including:

Psycho-education: teaching both the kid and the family more about the symptoms and the illness.

Therapy, particularly cognitive behavioral therapy: "CBT can be good to change one's thinking patterns," says Correll, "and also to address developing self-esteem. We have to be careful that kids with a psychiatric diagnosis don't self-stigmatize and get into a hopeless or negative mode where they feel they can't achieve."

Lifestyle adjustments: Assessing whether the current school environment is best for the child. Perhaps a therapeutic social group to help the child cope.

Reducing Stress: Stress is often a trigger for symptoms, so reducing stress in these kids' lives is crucial and may prevent or delay conversion to psychotic illness.

Understanding prodromal symptoms and monitoring kids who are at high risk for psychotic illness means that parents can do more for their kids than wait for symptoms to get worse or merely hope for the best. Early monitoring and intervention can give high-risk kids an advantage, which researchers hope will eventually change the odds when it comes to psychotic illness.

"The duration of untreated psychosis does actually seem to affect the course of the illness," Dr. Colibazzi says. The longer the illness goes untreated, the greater the chance that it will cause serious disruption in all areas of the patient's life. "So it is reasonable to think that just following someone very closely and treating them very early, as soon as they develop symptoms, would be helpful."

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Psychosis Symptoms and Signs in Teens | Child Mind Institute

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There are fewer more frightening or challenging psychiatric conditions for a family to face than psychosis, an extreme mental state in which impaired thinking and emotions cause a person to lose contact with reality. This could mean hearing or seeing things that aren't there (hallucinations), or believing things that aren't true (delusions).

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Teaching and Understanding Students with Schizophrenia_ Lesson Plans

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There is a rising concern amongst educators that the challenges brought about by the COVID-19 pandemic will create difficulty in forming the relationship they need to connect with, motivate, and teach their students. In this webinar, they provide insights from education leaders on how to prepare for the coming school year, in a time that is unprecedented in our history. They share insights and ideas for counselors on how to connect with students, make learning relevant in this challenging time, and help them to develop greater resilience.

This panel discussion includes these presenters:

Ashley Wright
Ashley is a passionate educator and student advocate. She currently works as a school counselor in Conroe ISD, Texas. She has been an educator for the past 13 years and is currently employed in Conroe Independent School District in Conroe, Texas. She recently received the 2019 "Elementary School Counselor of the Year" for Texas School Counselor Association and is currently serving on the TSCA board as an Emerging Leader. Last but not least, she LOVVVES school counseling!

Christian Moore
Christian Moore is an internationally-renowned speaker, licensed clinical social worker, and advocate for youth. He is the author of The Resilience Breakthrough and founder of the WhyTry Program.

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The New 3 R's for School Counselors: Relationship, Relevance, and Resilience

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There is a rising concern amongst educators that the challenges brought about by the COVID-19 pandemic will create difficulty in forming the relationship they need to connect with, motivate, and teach their students. In this webinar, they provide insights from education leaders on how to prepare for the coming school year, in a time that is unprecedented in our history.

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Childhood experiences, both positive and negative, have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. As such, early experiences are an important public health issue. Much of the foundational research in this area has been referred to as Adverse Childhood Experiences (ACEs).

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Role of the School Counselor | American School Counselor Association (ASCA)

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At a glance

The Individuals with Disabilities Education Act (IDEA) requires public schools to provide special education services to eligible students.

IDEA covers 13 disability categories.

Not every student who struggles in school qualifies.

The Individuals with Disabilities Education Act (IDEA) requires public schools to provide special education and related services to eligible students. But not every child who struggles in school qualifies. To be covered, a child's school performance must be "adversely affected" by a disability in one of the 13 categories below.

1. Specific learning disability (SLD)

The "specific learning disability" (SLD) category covers a specific group of learning challenges. These conditions affect a child's ability to read, write, listen, speak, reason, or do math. Here are some examples of what could fall into this category:

SLD is the most common category under IDEA. In the 2018-19 school year, around 33 percent of students who qualified did so under this category.

2. Other health impairment

The "other health impairment" category covers conditions that limit a child's strength, energy, or alertness. One example is ADHD, which impacts attention and executive function.

3. Autism spectrum disorder (ASD)

ASD is a developmental disability. It involves a wide range of symptoms, but it mainly affects a child's social and communication skills. It can also impact behavior.

Various mental health issues can fall under the "emotional disturbance" category. They may include anxiety disorder, schizophrenia, bipolar disorder, obsessive-compulsive disorder, and depression. (Some of these may also be covered under "other health impairment.")

5. Speech or language impairment

This category covers difficulties with speech or language. A common example is stuttering. Other examples are trouble pronouncing words or making sounds with the voice. It also covers language problems that make it hard for kids to understand words or express themselves.

6. Visual impairment, including blindness

A child who has eyesight problems is considered to have a visual impairment. This category includes both partial sight and blindness. If eyewear can correct a vision problem, then it doesn't qualify.

Kids with a diagnosis of deafness fall under this category. These are kids who can't hear most or all sounds, even with a hearing aid.

The term "hearing impairment" refers to a hearing loss not covered by the definition of deafness. This type of loss can change over time. Being hard of hearing is not the same thing as having trouble with auditory or language processing.

Kids with a diagnosis of deaf-blindness have both severe hearing and vision loss. Their communication and other needs are so unique that programs for just the deaf or blind can't meet them.

10. Orthopedic impairment

An orthopedic impairment is when kids lack function or ability in their bodies. An example is cerebral palsy.

11. Intellectual disability

Kids with this type of disability have below-average intellectual ability. They may also have poor communication, self-care, and social skills. Down syndrome is one example of a condition that involves an intellectual disability.

12. Traumatic brain injury

This is a brain injury caused by an accident or some kind of physical force.

13. Multiple disabilities

A child with multiple disabilities has more than one condition covered by IDEA. Having multiple issues creates educational needs that can't be met in a program designed for any one disability.

Having a disability is not enough to qualify for special education. The disability has to have an "adverse effect" on a child's education.

Key takeaways

Each of the 13 disability categories in IDEA can cover a range of difficulties.

Dyslexia, dyscalculia, and written expression disorder fall under the "specific learning disability" category.

"Other health impairment" can cover ADHD.

About the author

About the author

Andrew M.I. Lee, JD is an editor and attorney who strives to help people understand complex legal, education, and parenting issues.

Reviewed by

Reviewed by

Rayma Griffin, MA, MEd has spent 40 years working with children with learning and thinking differences in the classroom and as an administrator.

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See a list of the 13 IDEA disability categories. Find out which disabilities can qualify kids for special education.

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Individuals with Disabilities Education Act

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Individuals with Disabilities Education Act (IDEA)

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The U.S. Department of Education’s Individuals with Disabilities Education Act website brings together department and grantee IDEA information and resources. The IDEA makes available a free appropriate public education to and ensures special education and related services to eligible children with disabilities.

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According to Section 33 of the Texas Education Code, it is a school counselor's responsibility to help each student develop their academic, career, personal, and social abilities through a comprehensive developmental guidance program. A school counselor works as a team with staff, parents, and the community to create a successful atmosphere for students.

A school counselor plans, organizes, implements, and evaluates a comprehensive developmental guidance program that promotes the educational, career, personal, and social development of students. The comprehensive developmental guidance program should include the following 4 components: guidance curriculum, responsive services, individual planning system, and system support.

Guidance Curriculum is taught through classroom instruction by the school counselor as a preventative or remedial measure that focuses on the developmental needs of students. School counselors use the American School Counselor Association National Model and Texas Model to adapt their program to their school's needs. Both of these models provide competencies and desired learning outcomes that play a key role in accountability. Examples of guidance units may include academic support (test-taking skills for instance), goal setting, career awareness, peer relationships, communication, problem solving, conflict resolution, diversity awareness, etc.

Responsive Services includes meeting with individual or small groups of students to counsel. Small group counseling services are available through teacher referral, parent referral, staff referral or self-referral by any student. Short-term individual counseling is available as needed. Counselors might also consult with parents, staff, or educators, refer students to other school support services or community resources, and provide intervention or advocacy at a systemic level.

An I ndividual Planning System helps students plan, monitor, and manage the decisions needed to be made throughout their educational career to establish goals and develop future plans. It educates students on understanding themselves and their strengths and weaknesses.

System Support involves supporting the staff, parents, and members of the community in the context of the program's goals. This includes consulting and coordinating to help increase the effectiveness of the program and promote student success. It may also involve professional development.

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According to Section 33 of the Texas Education Code, it is a school counselor's responsibility to help each student develop their academic, career, personal, and social abilities through a comprehensive developmental guidance program. A school counselor works as a team with staff, parents, and the community to create a successful atmosphere for students.

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These customizable behavior charts are available for free to Empowering Parents readers. Each chart includes detailed instructions on how to use them with your child. Click here to read the accompanying article with more details about how to use these charts most effectively.

Download them today, print as many copies as you need on your printer, and start using them right away to assist with getting your child to do chores or homework and help correct any behavior issues you are struggling with.

Click on the links below to get more details about each chart and to download the charts in PDF format.

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Correct Bad Behavior - Customizable Behavior Charts

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These customizable behavior charts are available for free to Empowering Parents readers. Each chart includes detailed instructions on how to use them with your child. Click here to read the accompanying article with more details about how to use these charts most effectively.

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Texas has a population of approximately 26.9 million people making it the 2nd most populated state in the nation. Close to 3.68% of adults (according to SAMHSA) in the state of Texas live with serious mental health conditions such as schizophrenia, bipolar disorder, and major depression.

Public mental health and substance use services in Texas are administered and provided by the Texas Department of State Health Services-Mental Health and Substance Abuse Division.

Only 38.3% of adults with mental illness in Texas receive any form of treatment from either the public system or private providers (according to SAMHSA). The remaining 61.7% receive no mental health treatment. According to Mental Health America, Texas is ranked 32 out of the 50 states and Washington D.C. for providing access to mental health services.

Medicaid is a combined state and federal program that provides health coverage to people with low income, including those who are unable to work because of a mental health disability. Residents of Texas can apply for Medicaid through the Texas Health Marketplace.

Other Texas Resources

Texas Department of State Health Services- Mental Health and Substance Abuse Division

Texas Medicaid

Texas 211 - 2-1-1 is a free referral and information helpline that connects people to a wide range of health and human services, 24 hours a day, 7 days a week. To contact 2-1-1 in any state, including Texas, simply dial the numbers 2-1-1 from any phone.

National Alliance on Mental Illness-Texas - The National Alliance on Mental Illness is a nationwide advocacy group, representing families and people affected by mental health disorders in the United States. The national organization is organized into state and local affiliates, of which NAMI-Texas is one.

Texas Medicaid

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Texas has a population of approximately 26.9 million people making it the 2nd most populated state in the nation. Close to 3.68% of adults (according to SAMHSA) in the state of Texas live with serious mental health conditions such as schizophrenia, bipolar disorder, and major depression.

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Children with OCD have intrusive thoughts and worries that make them extremely anxious, and they develop rituals they feel compelled to perform to keep those anxieties at bay. This guide explains the often confusing behaviors that can be associated with OCD, and the treatments most effective for hel…

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Treating OCD in Children & Adolescents: Signs of OCD

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares.

Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry. These are called obsessions. To alleviate the anxiety caused by their obsessive thoughts, they perform repetitive, ritualized actions called compulsions. A child with OCD might need to line things up, touch things in a certain order when leaving the room or wash his hands repeatedly.

Obsessions Common in Kids With OCD

Contamination: Kids with this obsession are sometimes called "germaphobes." In schools, this plays out with kids worrying about other kids sneezing and coughing, touching things that might be dirty or getting sick in many different ways. This is the most common obsession seen in children.

Magical thinking: This is a kind of superstition, like "step on a crack, break your mother's back," taken to extremes. For example, kids might worry that their thoughts can cause someone to get hurt, or get sick. A child might think, "Unless my things are lined up in a certain way, mom will get in a car accident."

Catastrophizing: Some kids easily jump to the conclusion that something terrible has happened. For example, if her parents are five minutes late picking her up, a girl who is catastrophizing might tell herself that they've decided to abandon her.

Scrupulosity: This is when kids have obsessive worries about offending God or being blasphemous in some way.

What ifs: Kids may be plagued by a lot of different kinds of thoughts about bad things they could do. "What if I hurt someone? What if I stab someone? What if I kill someone?"

The "just right feeling": When OCD first develops, from about 6 to 9 years of age, kids may not know why they are doing something, but just that they need to do it until they get what we call the "just right feeling." So: "I'll line these things up until it just kind of feels right, and then I'll stop." And then over time - in the 9- to 12-year-old range - it evolves into magical thinking and becomes more superstitious in nature.

Behaviors You Might See in Students With OCD

Frequent requests to go to the bathroom: This could be to wash hands, if someone near the child was coughing or sneezing, or if she touched something that she perceives as contaminated. She could be washing items-pens, pencils, backpacks, books. It could also be an excuse to get out the classroom and just be away from everyone, and have some respite.

Constant reassurance-seeking: This takes the form of repetitive questions. "Are you sure that's the answer? Could you tell me again? Did you hear what I said?" Checking doors, windows, lockers, desks. Over and over and over again.

Getting stuck on tasks: Sometimes kids with OCD will need to finish something to completion, or understand it to completion, before they're able to move on. So if a child is working out what he did wrong on a math test, and the teacher says, "Now let's open the textbook and start a new chapter," he's not going to be able to shift gears.

Retracing: If a child leaves the classroom and worries that she left a pencil behind, she'll go back into the classroom and go to her desk and check. If she had a bad thought as she went through the doorway, she might have to "fix it" by going back through the doorway again saying a good word. If she had a bad thought when she went down a flight of stairs on the way to class, she might need to go back up that same stairway at the end of the period, even if it means being late to her next class.

Obsessive erasing: A child could be erasing a lot because the letters have to look perfect. Or he could have used a word that disturbs him. For example, if he has a fear of vomiting and he's written the word vomit, he might not be able to stand seeing that word, so he erases it. Kids start having erasers worn down to the metal. Teachers start to see holes in the paper. Words will be drawn over on the back of the page. A lot of different areas of writing become problematic.

Behaviors Often Confused With Another Disorder

Some behaviors associated with OCD are easy to confuse with ADHD, learning problems or being oppositional.

Distraction: If a child is busy thinking that if she doesn't turn the pen cap and count to four the right way then her mom is going to get sick, she's not going to be paying attention in class. And if her teacher calls on her to answer a question, her distraction might look like ADHD, but it isn't.

Slowness on exams, papers and tasks: Sometimes when kids take a long time, they're struggling with the perfectionism of needing to do things the right way. This could look like learning problems, or inattention, but it isn't.

Avoidance: Teachers might see a child who doesn't want to sit on the floor, or pick things up that touched the floor, or get his hands dirty in art class. He may avoid a lot of playground activities - kids with germ fears will view the playground the way some adults view the subway: it's gross. Why touch anything there?

Tapping and touching symmetrically: If a child sits down at her desk and she accidentally kicks the chair of the kid next to her with her right foot, she's going to have to then kick it with her left foot. That might look like somebody who's being oppositional, or somebody who's got too much energy, but actually it's OCD.

Complaints of anxiety and fatigue: There's one interesting theory that kids with OCD are smarter than other kids. And if you consider how much thinking they're doing, they're really using their brain more frequently than a lot of other kids are. But when that's coupled with a lot of anxiety, you can have a lot of fatigue. So it's common for kids with OCD to want to come home and take a nap after school.

How to Help Students With OCD

For children struggling with OCD, functioning in school can be complicated and very difficult. Here are some things you can do to help them, and the class as a whole, focus on learning:

Seating arrangement: If the school has noisy hallways, you might not want to have a child with OCD sit by the door. You might have her sit in the front, where she's less able to hear the noise and can stay more focused on her work. On the other hand, a child who has very observable symptoms, and doesn't want other kids to see her fidgeting with her hands, rocking or getting up a lot, might be better off closer to the door, toward the back of the room.

Extended time for tests and papers: If writing is a problem for a child who needs to find the perfect way to say something, he's going to need more time to finish those essay questions or papers.

Laptops for writing: If writing and rewriting/erasing is really problematic for a child, consider letting her use a laptop for taking notes, and having all assignments be typed instead of handwritten.

Private testing rooms: Research is quite clear that kids with OCD do better, are less overwhelmed and are more in control of their thoughts and their reactions if they're in a quiet place away from the other kids.

Skip reading out loud: Kids who feel they need to read perfectly may have to go back and reread sentences or whole paragraphs over and over to make sure they've got them right. So reading becomes a very laborious task, and reading in front of the class can become a nightmare. So if we know doing this is a problem for children, we can spare them.

Books on tape: If kids get so hung up reading that it takes forever, listening to the books can be a solution.

Break homework into chunks: If looking at a whole page of math makes kids feel overwhelmed and anxious - think of the potential for mistakes! - the problems can be broken up over four pages. It helps kids stay focused on doing the problems instead of worrying.

How to Minimize Behavioral Problems

Plan an escape route: Try working out a communication system so that if the student feels symptoms coming on, she can signal to you and leave the classroom, or go to a protected place in the classroom, without interrupting the class. It can prevent an embarrassing and disruptive blowup of symptoms in the classroom, and the other kids picking on or bullying her about it.

Be aware of triggering events: It's very important for teachers to know what kind of things might trigger the symptoms. Fatigue is a huge piece of OCD, and it can be exacerbated by medication. So it's important to know that if a child is drowsy in class, and maybe he's putting his head down, it's not because he's being oppositional or disrespectful, but because he's overwhelmed with fatigue.

Advance notice: Irritability and frustration are two of the longer-lasting things that kids with OCD are feeling on a daily basis. Changes in schedule can be very disruptive for a child with OCD, so it can be helpful for teachers to give advance notice of things. Kids who know what to expect are less likely to be thrown by the change.

Children with OCD are often teased and bullied because of their symptoms. Kids feel very uncomfortable about their rituals, knowing that they're being watched. It can be helpful to educate the whole class about what's going on, especially if a child is going to be in the same school for a number of years, and it can inspire a surprising amount of support from other children.

Peer understanding program: A peer understanding program includes a presentation in the classroom that explains (with the child participating) what OCD is. The child might say, "Listen, I have OCD. It's an anxiety disorder. It makes me think that my hands are dirty and I have to wash my hands a lot, so if you see me getting up and going to the sink to wash my hands, that's why." Psychologists can role-play with the teacher and child ahead of time, to anticipate questions his classmates might ask, and how to answer them.

A buddy system: A buddy is like a peer coach who sits next to the child and prompts him to keep up with note taking and staying on task. It can be great for the buddy, to foster a sense of confidence and pride and to be able to help someone in need, and great for fostering friendship.

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Lo sentimos, la página que usted busca no se ha podido encontrar. Puede intentar su búsqueda de nuevo o visitar la lista de temas populares. Children who have obsessive-compulsive disorder (OCD) are plagued with unwanted thoughts, images or impulses that are difficult to suppress, causing them great stress and worry.

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"Lane, I will become attached to you. It happens with everyone. Something about my personality makes me latch on to people. First, it was my friend Tina, then Liam, and now you. I'm sorry, but I know it will happen. It already is happening. Now that we've had sex, I don't want you out of my sight."
― K. Webster, Apartment 2B

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"I had to stop him from arresting an old lady who let her dog urinate against the fire hydrant that was in front of Burgerville headquarters. "You'll blow our cover.""But what if there is a fire?""The fire department will come and put it out," I said."With what?""Water," I said."Not from that hydrant," Monk said.

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Centers for Disease Control and Prevention

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Many children have fears and worries, and may feel sad and hopeless from time to time. Strong fears may appear at different times during development. For example, toddlers are often very distressed about being away from their parents, even if they are safe and cared for. Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression. Because the symptoms primarily involve thoughts and feelings, they are sometimes called internalizing disorders.

Anxiety

When a child does not outgrow the fears and worries that are typical in young children, or when there are so many fears and worries that they interfere with school, home, or play activities, the child may be diagnosed with an anxiety disorder. Examples of different types of anxiety disorders include

Being very afraid when away from parents (separation anxiety)

Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)

Being very afraid of school and other places where there are people (social anxiety)

Being very worried about the future and about bad things happening (general anxiety)

Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic disorder)

Anxiety may present as fear or worry, but can also make children irritable and angry. Anxiety symptoms can also include trouble sleeping, as well as physical symptoms like fatigue, headaches, or stomachaches. Some anxious children keep their worries to themselves and, thus, the symptoms can be missed.

Related conditions include Obsessive-Compulsive Disorder and Post Traumatic Stress Disorder.
Learn more about anxiety in children
Depression

Occasionally being sad or feeling hopeless is a part of every child's life. However, some children feel sad or uninterested in things that they used to enjoy, or feel helpless or hopeless in situations they are able to change. When children feel persistent sadness and hopelessness, they may be diagnosed with depression.

Examples of behaviors often seen in children with depression include

Feeling sad, hopeless, or irritable a lot of the time

Not wanting to do or enjoy doing fun things

Showing changes in eating patterns - eating a lot more or a lot less than usual

Showing changes in sleep patterns - sleeping a lot more or a lot less than normal

Showing changes in energy - being tired and sluggish or tense and restless a lot of the time

Having a hard time paying attention

Feeling worthless, useless, or guilty

Showing self-injury and self-destructive behavior

Extreme depression can lead a child to think about suicide or plan for suicide. For youth ages 10-24 years, suicide is among the leading causes of death. Read about youth suicide prevention.

Some children may not talk about their helpless and hopeless thoughts, and may not appear sad. Depression might also cause a child to make trouble or act unmotivated, causing others not to notice that the child is depressed or to incorrectly label the child as a trouble-maker or lazy.
Learn more about depression in children
Treatment for anxiety and depression

The first step to treatment is to talk with a healthcare provider such as your child's primary care provider, or a mental health specialist, about getting an evaluation. The United States Preventive Services Taskforce recommends screening for anxiety in children aged 8 to 18 years and for depression in adolescents aged 12 to 18 years. Some of the signs and symptoms of anxiety or depression in children could be caused by other conditions, such as trauma. Specific symptoms like having a hard time focusing could be a sign of attention-deficit/hyperactivity disorder (ADHD). It is important to get a careful evaluation to get the best diagnosis and treatment. Consultation with a health provider can help determine if medication should be part of the treatment. A mental health professional can develop a therapy plan that works best for the child and family. Behavior therapy includes child therapy, family therapy, or a combination of both. The school can also be included in the treatment plan. For very young children, involving parents in treatment is key. Cognitive-behavioral therapy is one form of therapy that is used to treat anxiety or depression, particularly in older children. It helps the child change negative thoughts into more positive, effective ways of thinking, leading to more effective behavior. Behavior therapy for anxiety may involve helping children cope with and manage anxiety symptoms while gradually exposing them to their fears so as to help them learn that bad things do not occur.

Treatments can also include a variety of ways to help the child feel less stressed and be healthier like nutritious food, physical activity, sufficient sleep, predictable routines, and social support.

Get help finding treatment

Here are tools to find a healthcare provider familiar with treatment options:

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with depression or anxiety. In addition to getting the right treatment, leading a healthy lifestyle can play a role in managing symptoms of depression or anxiety. Here are some healthy behaviors that may help:

Prevention of anxiety and depression

It is not known exactly why some children develop anxiety or depression. Many factors may play a role, including biology and temperament. But it is also known that some children are more likely to develop anxiety or depression when they experience trauma or stress, when they are maltreated, when they are bullied or rejected by other children, or when their own parents have anxiety or depression.

Although these factors appear to increase the risk for anxiety or depression, there are ways to decrease the chance that children experience them. Learn about public health approaches to prevent these risks:

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Anxiety and Depression in Children | CDC

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Although fears and worries are typical in children, persistent or extreme forms of fear and sadness could be due to anxiety or depression. Learn about anxiety and depression in children.

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Icebergs are deceiving because what you see on the surface is usually only a small fraction of what lies below. Observing the behavior of an anxious child is sometimes like looking at the tip of an iceberg: underlying the anxious behavior are layers of emotions and experiences. Therapists often illustrate this idea with an image like this:

While the image above can be eye-opening, there's a huge assumption that parents can actually recognize that tip of the iceberg or look at a child's behavior and say, "Yup, that's anxiety." Here's the reality: anxious behavior in children is not uniform.

Your child might ask repetitive questions for reassurance and no matter how many times you answer, the question repeats. You might have the perfect child at school that comes home and constantly picks fights with you or siblings. You may have a child that can't focus, motivate, or even loses sleep at night. Or maybe your child is downright angry. Anxiety, in fact, can manifest in a multitude of forms. In our work at GoZen!, we see anxiety showing up 8 different ways. This makes the iceberg look more like this:

Let's try to understand why anxiety manifests in these ways by taking a deeper dive into each:

1. Difficulty Sleeping

Anxiety and sleep problems have a chicken and egg connection. Research has shown that anxiety can lead to sleep disorders and chronic sleep disruption can lead to anxiety. In children, having difficulty falling asleep or staying asleep is one of the hallmark characteristics of anxiety. In many kids, trains of anxious thoughts keep them awake long after they should be asleep. Others have anxiety about falling asleep, thinking they will miss their alarm or be tired in the morning.

2. Anger

The link between anger and anxiety is an under-researched area, but in our work, the manifestation of anger in anxious children is clear. Here are some hypotheses as to why there is a link. Anxiety occurs when there is an overestimation of a perceived threat (e.g., a test or a party) and an underestimation of coping skills (e.g.,"I can't handle this."). When our kids are chronically and excessively worried and don't feel like they have to skills to manage the anxiety, they feel helpless. Helplessness leads to frustration which can show up as anger.

Anger and anxiety are also both activated in the threat center of your brain. When the brain perceives a threat, the amygdala (a small, almond-shaped cluster of neurons in the brain) activates the flight-or-fight response which floods your body with hormones to make you stronger and faster. This genetic wisdom protects us from threats and danger. Because anger and anxiety are both activated from the same brain region and have similar physiological patterns (rapid breathing, heart racing, pupils dilating etc.), it's possible that when your child feels like there is a threat (e.g. going to a party), the fight or anger response is activated as a form of protection.

Finally, one of the markers of generalized anxiety is "irritability" which is also part of the anger family.

3. Defiance

There is nothing more frustrating to a child with anxiety than feeling like their life is out of control. As a way of feeling secure and comforted, they seek to take back control, often in unexpected and peculiar ways. For example, a child already experiencing the flood of stress hormones at the prospect of going to bed, lashes out at being given an orange cup instead of a blue one. Unable to communicate what is really going on, it is easy to interpret the child's defiance as a lack of discipline instead of an attempt to control a situation where they feel anxious and helpless.

4. Chandeliering

To borrow a term from renowned social scientist, Brené Brown, chandeliering is when a seemingly calm person suddenly flies off the handle for no reason. In reality, they have pushed hurt and anxiety so deep for so long that a seemingly innocent comment or event suddenly sends them straight through the chandelier. A child who goes from calm to a full-blown tantrum without a reason is often ill-equipped to talk about their anxiety and tries to hide it instead. After days or even weeks of appearing "normal" on the surface, these children will suddenly reach a point where they cannot hide their anxious feelings anymore and have a disproportionate reaction to something that triggers their anxiety.

5. Lack of Focus

According to the Centers for Disease Control , 6.1 million children have been diagnosed with some form of Attention Deficit Hyperactivity Disorder in the US. In the past research has suggested that ADHD and anxiety often go hand in hand. But studies have shown that children with anxiety don't necessarily have ADHD more often. Instead, these two conditions have symptoms that overlap - a lack of focus and inattention being two of them. Children with anxiety are often so caught up in their own thoughts that they do not pay attention to what is going on around them. This is especially troublesome at school where they are expected to pay attention to a teacher for hours at a time.

6. Avoidance

As humans, we have a tendency to avoid things that are stressful or uncomfortable. These avoidance behaviors happen in two forms - doing and not doing. If you are trying to avoid getting sick, you may wash your hands repeatedly throughout the day (doing). If you are avoiding a person that makes you feel uncomfortable, you may skip a party or meeting (not doing). The only problem with avoidance is that it often snowballs. Children who are trying to avoid a particular person, place or task often end up experiencing more of whatever it is they are avoiding. If schoolwork is the source of a kid's anxiety, they will go to great lengths to avoid it and in the process end up having to do more to make up for what they missed. They will have also spent time and energy on avoiding it in the process, making it the source of greater anxiety in the end.

7. Negativity

From a neurological standpoint, people with anxiety tend to experience negative thoughts at a much greater intensity than they do positive ones. As a result, negative thoughts tend to take hold faster and easier than positive ones, making someone with anxiety seem like a downer all of the time. Children with anxiety are especially prone to these patterns because they have not yet developed the ability to recognize a negative thought for what it is and turn it around by engaging in positive self-talk.

8. Overplanning

Overplanning and defiance go hand in hand in their root cause. Where anxiety can cause some children to try to take back control through defiant behavior, it can cause others to overplan for situations where planning is minimal or unnecessary. A child with anxiety who has been invited to a friend's birthday party may not only plan what they will wear and what gift to take, they will ask questions about who else will be there, what they will be doing, when their parent will pick them up, what they should do if someone at the party has an allergy, who to call if they get nervous or uncomfortable, who they can talk to while they are there... Preparing for every possibility is a way a child with anxiety takes control of an uncontrollable situation.

Have an anxious child? Take a deep dive into the animated GoZen! programs to teach your kids skills of resilience and well-being.

References

https://adaa.org/understanding-anxiety/related-illnesses/sleep-disorders

https://www.cdc.gov/ncbddd/adhd/data.html

https://www.cambridge.org/core/journals/psychological-medicine/article/childhood-attention-deficithyperactivity-disorder-in-adults-with-anxiety-disorders/C54916B9CC9B1578DAFCB2EA08550186

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1469-8986.2010.00997.x

https://www.psychologytoday.com/us/blog/in-practice/201303/why-avoidance-coping-is-the-most-important-factor-in-anxiety

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8 Ways A Child's Anxiety Shows Up as Something Else | GoZen!

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Icebergs are deceiving because what you see on the surface is usually only a small fraction of what lies below. Observing the behavior of an anxious child is sometimes like looking at the tip of an iceberg: underlying the anxious behavior are layers of emotions and experiences.

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Anxiety and worry can creep up on your kids when you least suspect it. Luckily there's a solid stable of books that parents can turn to as they help their little ones better cope.

And books can be especially useful for kids when talking about conditions like anxiety, said Natasha Daniels, child therapist and author of How To Parent Your Anxious Toddler and Anxiety Sucks! A Teen Survival Guide.

"I do think kids learn through stories so either if a child has a hard time talking about it or if we want to normalize it, it's super helpful to say, 'Look, it's in this book,'" she told HuffPost. "When we distance it and it's not about the child, it's just about this character in this book."

Casey Strenski, a registered associate marriage and family therapist, is the clinical program director of Los Angeles' Mindful Heart Kids, which offers therapeutic programs for children. She echoed Daniels' idea and described children's books as "a really good tool" to help kids learn about their feelings, especially when they can turn to the visuals for added context.

HuffPost put together a list of helpful titles, a mix of recommendations from therapists, counselors, psychologists and other mental health experts as well as some other notable books of the past few years.

Some are fictionalized accounts that highlight common worrisome scenarios like the first day of school, while others are workbooks that offer coping strategies for kids with anxiety. Check them out below.

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17 Children's Books For Kids Struggling With Anxiety And Worry

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Anxiety and worry can creep up on your kids when you least suspect it. Luckily there's a solid stable of books that parents can turn to as they help their little ones better cope. And books can be especially useful for kids when talking about conditions like anxiety, said Natasha Daniels, child therapist and author of How To Parent Your Anxious Toddler and Anxiety Sucks!

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The scales are copyrighted to the author and may not be reprinted in full in any publication nor resold for commercial purposes. Information from the site, including the Spence Children's Anxiety Scale, may currently be downloaded and used free of charge by researchers and individual practitioners. Commercial organizations and for-profit clinical services should contact the author to discuss a commercial licence arrangement before use. Not-for-profit and government agencies should seek prior permission from the author to use the scale within their organizations, and a charge may apply.

Permission should also be sought from the author from those wishing to translate a scale into another language or to modify it in any way.

The scales are intended for research or for clinical use under the supervision and care of a trained mental health clinician. Their clinical use for any particular case is the responsibility of the clinician and the author does accept any liability with respect to their use.

HELP NEEDED: TRIALLING THE NEW PARENT SCAS AUTOMATIC SCORING TEMPLATES

The parent SCAS automatic scoring templates have now been prepared and the author is inviting a few clinicians to try them out.

The task involves administering the new questionnaire templates with a few of your clients with whom you are using the SCAS and checking that the automatic scoring result is the same as you get when you score it manually and check that the T-scores are the same as those on the T-score chart. It would be helpful to have some feedback to make sure that the templates are absolutely correct before I put them on the website for download. I'm hoping to do this over the next 3-4 weeks.

There are separate versions for boys and girls in age groups 7-9 years and 10-13 years.

If you are interested in trialling them and sending feedback, please email s.spence@griffith.edu.au

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This site includes information about the Spence Children's Anxiety Scale (Child and Parent Versions) and the Preschool Anxiety Scale, plus a other resources developed by the author that you may find useful.

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The scales are copyrighted to the author and may not be reprinted in full in any publication nor resold for commercial purposes. Information from the site, including the Spence Children's Anxiety Scale, may currently be downloaded and used free of charge by researchers and individual practitioners.

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It's common for kids who struggle in school to experience stress and anxiety. But are stress and anxiety the same thing? Many people use the terms interchangeably. The fact is, though, that stress and anxiety-while related-are different. And understanding the difference can help you find the best ways to help your child.

Read on to learn more about the connection between stress and anxiety.

Stress and anxiety are closely related, but they're not the same thing.

Make us feel nervous, angry, and frustrated.

Have a positive effect. For example, it can "pump up" a child to study for a test.

Be overwhelming. Feeling stress every day for a long time can take a toll on your body and mind.

Anxiety is different. It's a reaction to stress. It's the feeling kids get when they don't think they can handle the thing (or challenge) that's putting pressure on them. That lack of control makes kids feel worried and afraid.

Here are some common aspects of anxiety:

An anxious feeling is often out of proportion to the real or imagined "threat" (for example, a child crying in terror because she's afraid to enter a birthday party).

Anxious children may expect that something bad will happen and not believe they'll be able to handle it. (That dog's going to bite me and I'm going to die!)

"What if?" is a common phrase anxious kids say and think.

Avoid COVID Slide with tips and tools designed to help your child return to the classroom.

As with stress, all kids feel anxious from time to time. Here are some common signs of anxiety:

When Stress Leads to Anxiety

When kids feel stress for an extended period of time, they may have what's called chronic stress.

For example, kids who struggle with math typically experience more failure with math than success. Every time they have to do a math problem, they feel stressed. When they do math homework, they may make errors that make them feel "stupid" the next day-and the stress continues. That's chronic stress.

Chronic stress can lead to anxiety. Kids who experience chronic stress may start to think they just can't do certain things. They develop a sense of worry or fear that no matter what they do, they'll still fail. That's anxiety.

To break the cycle and prevent anxiety, it's important to help kids balance the "I cans" with the "I can'ts." They need to experience the joy of success more often. One way to do this is by setting a competence anchor-helping kids connect the feeling of something they're successful at with a task they're struggling with. (Learn more about how to set a competence anchor.)

Anxiety and Kids Who Struggle in School

Just about everyone feels anxiety at some point. But kids who struggle in school may have extra reasons for feeling worried and afraid. These include:

Anxiety about not being able to keep up: Struggling students may notice they have trouble doing what their friends can do easily. They may be too hard on themselves in general or feel anxious about specific things, like tests.

Anxiety about feeling different: Kids who don't do as well as their peers may worry they don't fit in. And kids who get extra support, like accommodations, might worry their classmates will notice they get more time on tests or will see them in the resource room.

Anxiety about the future: Teens who struggle in school may fear what's after high school. "If I can't pass a math test, how will I ever take the SAT?" Or they may worry they won't be able to live away from home.

Anxiety is especially common in kids with ADHD. Some of the challenges that come along with ADHD can make kids anxious, like trouble with working memory and organization. These built-in challenges can make it hard for kids to have a sense of control. This increases anxiety.

Other learning and thinking differences can be closely related to anxiety, too. Learn more about:

Stress is a natural response to a challenge. It can make us feel nervous or even "pumped up."

Chronic stress can lead to anxiety, or a feeling of worry or fear.

When anxiety stops your child from enjoying life, it may be time to consider outside help.

About the Author

About the Author

The Understood Team

is made up of passionate writers, editors, and community moderators. Many of them learn and think differently, or have kids who do.

Reviewed by

Reviewed by

Jerome Schultz, PhD

is a clinical neuropsychologist and lecturer in the Harvard Medical School Department of Child Psychiatry.

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The Connection Between Anxiety and Stress

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It's common for kids who struggle in school to experience stress and anxiety. But are stress and anxiety the same thing? Many people use the terms interchangeably. The fact is, though, that stress and anxiety-while related-are different. And understanding the difference can help you find the best ways to help your child.

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Links updated, November 2021
This information in Spanish

The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years. ( 1)

We refer to mental disorders using different "umbrella" terms such as emotional disturbance, behavioral disorders, or mental illness. Beneath these umbrella terms, there is actually a wide range of specific conditions that differ from one another in their characteristics and treatment. These include (but are not limited to):

anxiety disorders;

bipolar disorder (sometimes called manic-depression);

conduct disorders;

eating disorders;

obsessive-compulsive disorder (OCD); and

psychotic disorders.

You may be reading this fact sheet with one of these specific disorders in mind, or you may be looking for information about emotional disturbances in general. In either case, keep reading to find out what different emotional distubances have in common, how they are defined in federal law, and where to find more detailed information on specific disorders.
Quick-Jump Menu
Definition
IDEA defines emotional disturbance as follows:
We've chosen to use the term "emotional disturbance" in this fact sheet because that is the term used in the nation's special education law, the Individuals with Disabilities Education Act (IDEA).

"...a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression.

(E) A tendency to develop physical symptoms or fears associated with personal or school problems." ( 2)

As defined by IDEA, emotional disturbance includes schizophrenia but does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance. ( 3)

Characteristics

As is evident in IDEA's definition, emotional disturbances can affect an individual in areas beyond the emotional. Depending on the specific mental disorder involved, a person's physical, social, or cognitive skills may also be affected. The National Alliance on Mental Illness of Southern Arizona puts this very well:

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. ( 4)

Some of the characteristics and behaviors seen in children who have an emotional disturbance include:

Hyperactivity (short attention span, impulsiveness);

Aggression or self-injurious behavior (acting out, fighting);

Withdrawal (not interacting socially with others, excessive fear or anxiety);

Immaturity (inappropriate crying, temper tantrums, poor coping skills); and

Learning difficulties (academically performing below grade level).

Children with the most serious emotional disturbances may exhibit distorted thinking, excessive anxiety, bizarre motor acts, and abnormal mood swings.

Many children who do not have emotional disturbance may display some of these same behaviors at various times during their development. However, when children have an emotional disturbance, these behaviors continue over long periods of time. Their behavior signals that they are not coping with their environment or peers.

Causes

No one knows the actual cause or causes of emotional disturbance, although several factors-heredity, brain disorder, diet, stress, and family functioning-have been suggested and vigorously researched. A great deal of research goes on every day, but to date, researchers have not found that any of these factors are the direct cause of behavioral or emotional problems.

According to NAMI, mental illnesses can affect persons of any age, race, religion, or income. Further:

Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan. ( 5)

Frequency

Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a psychiatric disorder. ( 6) Half of all psychiatric illness occurs before the age of 14, and 75% by the age of 24. The most common psychiatric disorders in childhood are anxiety disorders, AD/HD and disruptive behavior, depression and bipolar disorders, and eating disorders. ( 7)

Help for School-Aged Children

IDEA requires that special education and related services be made available free of charge to every eligible child with a disability, including preschoolers (ages 3-21). These services are specially designed to address the child's individual needs associated with the disability-in this case, emotional disturbance, as defined by IDEA (and further specified by states). In the 2016 school year, more than 349,000 children and youth with emotional disturbance received these services to address their individual needs related to emotional disturbance. ( 8)

Determining a child's eligibility for special education and related services begins with a full and individual evaluation of the child. Under IDEA, this evaluation is provided free of charge in public schools.
10 Basic Steps in Special Education Questions Often Asked by Parents about Special Education Services Evaluating Children for Disability Developing Your Child's IEP
There is a lot to know about the special education process, much of which you can learn here on the CPIR site. We invite you to read the wide range of publications we offer on the topic, especially:

A Look at Specific Emotional Disturbances

As we mentioned, emotional disturbance is a commonly used umbrella term for a number of different mental disorders. Let's take a brief look at some of the most common of these.

We all experience anxiety from time to time, but for many people, including children, anxiety can be excessive, persistent, seemingly uncontrollable, and overwhelming. An irrational fear of everyday situations may be involved. This high level of anxiety is a definite warning sign that a person may have an anxiety disorder.

The term "anxiety disorder" is a broad term covering several different disabilities that share the core symptom of irrational fear. These include such different disorders as generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder (also called social phobia), and specific phobias. ( 9)

According to the Anxiety Disorders Association of America, anxiety disorders are the most common psychiatric illnesses affecting children and adults. ( 10) They are also highly treatable. Unfortunately, only about 36.9% of those affected receive treatment. ( 11)

Also known as manic-depressive illness, bipolar disorder is a serious medical condition that causes dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. ( 12)

For most people with bipolar disorder, these mood swings and related symptoms can be stabilized over time using an approach that combines medication and psychosocial treatment. ( 13)

Conduct Disorder

Conduct disorder refers to a group of behavioral and emotional problems in youngsters. Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way. ( 14) This may include some of the following behaviors:

aggression to people and animals;

destruction of property;

deceitfulness, lying, or stealing; or

truancy or other serious violations of rules. (15)

Treatment will depend on the child's symptoms, age, and general health. It will also depend on how severe the condition is. Treatment may include:

helping the child learn how to better solve problems, communicate, and handle stress, as well as how to control impulses and anger (what's known as cognitive-behavioral therapy);

family therapy;

peer group therapy (to help better social and interpersonal skills); and

medications (although these are not typically used to treat conduct disorder). (16)

Eating disorders are characterized by extremes in eating behavior-either too much or too little-or feelings of extreme distress or concern about body weight or shape. Females are much more likely than males to develop an eating disorder. ( 17)

Anorexia nervosa and bulimia nervosa are the two most common types of eating disorders. Anorexia nervosa is characterized by self-starvation and dramatic loss of weight. Bulimia nervosa involves a cycle of binge eating, then self-induced vomiting or purging. Both of these disorders are potentially life-threatening. ( 18)

Binge eating is also considered an eating disorder. It's characterized by eating excessive amounts of food, while feeling unable to control how much or what is eaten. Unlike with bulimia, people who binge eat usually do not purge afterward by vomiting or using laxatives. ( 19)

According to the National Eating Disorders Association:

Treating an eating disorder generally involves a combination of psychological and nutritional counseling, along with medical and psychiatric monitoring. Treatment must address the eating disorder symptoms and medical consequences, as well as psychological, biological, interpersonal, and cultural forces that contribute to or maintain the eating disorder... Many people utilize a treatment team to treat the multi-faceted aspects of an eating disorder. ( 20)

Obsessive-Compulsive Disorder

Often referred to as OCD, obsessive-compulsive disorder is actually considered an anxiety disorder (which was discussed earlier in this fact sheet). OCD is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors (handwashing, counting, checking, or cleaning) are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety. ( 21)

A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain. ( 22) Treatment for most people with OCD should include one or more of the following:

therapist trained in behavior therapy;

Cognitive Behavior Therapy (CBT);

medication (usually an antidepressant). (23)

"Psychotic disorders" is another umbrella term used to refer to severe mental disorders that cause abnormal thinking and perceptions. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. Schizophrenia is one type of psychotic disorder. ( 24) There are others as well.

Treatment for psychotic disorders will differ from person to person, depending on the specific disorder involved. Most are treated with a combination of medications and psychotherapy (a type of counseling). ( 25)

More about School

As mentioned, emotional disturbance is one of the categories of disability specified in IDEA. This means that a child with an emotional disturbance may be eligible for special education and related services in public school. These services can be of tremendous help to students who have an emotional disturbance.

Typically, educational programs for children with an emotional disturbance need to include attention to providing emotional and behavioral support as well as helping them to master academics, develop social skills, and increase self-awareness, self-control, and self-esteem. A large body of research exists regarding methods of providing students with positive behavioral support (PBS) in the school environment, so that problem behaviors are minimized and positive, appropriate behaviors are fostered. (See the resource section at the end of this fact sheet for more information on PBS.) It is also important to know that, within the school setting:

For a child whose behavior impedes learning (including the learning of others), the team developing the child's Individualized Education Program (IEP) needs to consider, if appropriate, strategies to address that behavior, including positive behavioral interventions, strategies, and supports.

Students eligible for special education services under the category of emotional disturbance may have IEPs that include psychological or counseling services. These are important related services available under IDEA and are to be provided by a qualified social worker, psychologist, guidance counselor, or other qualified personnel.

Recognizing and Addressing the Impact of COVID-19 | As young people return to in-person schooling in the 2021-2022 school year, they may bring with them the impact of the pandemic's trauma. This makes it essential that schools consider the possibility that many students will need to be re-evaluated to determine if they need additional services, especially behavioral support and mental health services, than they needed prior to COVID-19. Two resources of great relevance to reopening schools and returning students are the following:

Other Considerations

Children and adolescents with an emotional disturbance should receive services based on their individual needs, and everyone involved in their education or care needs to be well-informed about the care that they are receiving. It's important to coordinate services between home, school, and community, keeping the communication channels open between all parties involved.

The Importance of Support

Families often need help in understanding their child's disability and how to address the needs that arise from the disability. Help is available from psychiatrists, psychologists, and other mental health professionals that work in the public or private sector. There is also a network of mental health support operating in every state as well as locally.

To locate systems of support in your community or state, visit the organizations we've listed below. They can connect you with local resources, including support groups that provide connection and understanding, information, referral, and advocacy for those living with emotional disturbance.

There are also support groups available from organizations that address specific mental disorders under the umbrella term of emotional disturbance. See the resources at the end of this fact sheet to identify some of these groups.

Resources of More Information

AACAP | American Academy of Child and Adolescent Psychiatry | AACAP offers Facts for Families, a series in English, Spanish, and several other languages that includes many briefs on specific mental disorders, including the ones mentioned in this publication.

AACAP also operates different Resource Centers, which offer consumer-friendly definitions, answers to frequently asked questions, clinical resources, expert videos, Facts for Families, and much more. Visit the Resource Center home page if you are concerned with one of the following:

Anxiety Disorders

Autism

Bipolar Disorder

Conduct Disorder

Depression

Oppositional Defiant Disorder

NIMH | National Institute of Mental Health | NIMH is clearly a source of authoritative information on specific mental disorders. Phone: 1.866.615.6464. TTY: 1.866.415.8051

NAMI | National Alliance on Mental Illness | NAMI is an excellent source of information and connection on mental illness, including the individual disorders mentioned in this fact sheet. NAMI's website and toll-free helpline are available in English and Spanish.

SAMHSA is the Substance Abuse & Mental Health Services Administration. It offers many resources to consumers, including:.

Detailed information on specific emotional disturbances, or related issues such as positive behavior supports, is also available from these sources:

Anxiety Disorders Association of America | https://adaa.org/

Center on Positive Behavioral Interventions and Supports | The PBIS Center provides research-based information on how to provide behavioral supports to children who need them. | https://www.pbis.org

Conduct Disorders | A soft place to land for battle-weary parents
https://www.conductdisorders.com/community/

Encyclopedia of Mental Disorders | http://www.minddisorders.com/index.html

National Eating Disorders Association
1.800.931.2237 | www.nationaleatingdisorders.org

Something Fishy | (eating disorders)
https://www.something-fishy.org

**Highly Rated Resource! This resource was reviewed by 3-member panels of Parent Center staff working independently from one another to rate the quality, relevance, and usefulness of CPIR resources. This resource was found to be of "High Quality, High Relevance, High Usefulness" to Parent Centers.
________________________________________

References

2 | Code of Federal Regulations, Title 34, §300.8(c)(4)(i)

3 | Code of Federal Regulations, Title 34, §300.8(c)(4)(ii)

5 | Ibid.

7 | Ibid.

11 | Ibid.

13 | Ibid.

14 | American Academy of Adolescent and Child Psychiatry. (2013, August). Conduct disorder: Facts for families. Washington, DC: Author. Available online at:
http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Conduct_Disorder_33.aspx

15 | Ibid.

16 | Johns Hopkins Medicine Health Library. (n.d.). Conduct disorder in children. Baltimore, MD: Author. Online at:
https://www.hopkinsmedicine.org/healthlibrary/conditions/mental_health_disorders/conduct_disorder_90,P02560

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Links updated, November 2021 This information in Spanish The mental health of our children is a natural and important concern for us all. The fact is, many mental disorders have their beginnings in childhood or adolescence, yet may go undiagnosed and untreated for years.

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Definition

Students with emotional disorders are a very heterogeneous group with a wide range of issues that are unique to each individual. However, there are some key characteristics that are used to define this disability category, mostly relating to issues of personal identity and emotional well-being. An emotional disorder may be present if a student responds to a situation with an inappropriate behavior or emotion, and particularly, if this emotion is depression or long term unhappiness. Students with emotional disorders typically have a very difficult time maintaining personal relationships with others, and these personal problems lead to physical symptoms in time. If the student has difficulty learning, but there is no intellectual or sensory cause of this difficulty, then an emotional disorder may be to blame. This disability category does include some mental illnesses such as schizophrenia.

It should be noted that one or more of the previously mentioned characteristics has to be present for an extended period of time, and must have a negative impact on the student's academic performance before being considered an emotional disorder. Signs of an emotional disorder need to be taken seriously, as they can lead to physical aggression and self-injurious behavior. However, care must also be taken to recognize the difference between emotional disturbance and general teenage angst. There are as many causes of emotional disturbance in children as there are children in this category, but they can generally be divided into either biological causes, environmental causes, or a combination of the two.

Prevalence

The U.S. Department of Education reports 5,971,495 students receiving special education services in the 2003-2004 school year. Of that number, roughly 7.7%, or 461,055 students, received special education services based on a classification of emotional disturbance. However, within this group of 461,055 students, there was a definite disproportionally between gender, race and socioeconomic background. African-American students were far more likely to be diagnosed as emotionally disturbed than white students, reflecting possible race bias in this category. Research has pointed to a direct correlation between low income status and emotional disorders, but the exact reasons for this correlation are unknown.

Characteristics

Each student with an emotional disturbance will have characteristics that are unique to that individual. However, these students will all share deficits in three specific areas, namely emotional development, behavioral development, and cognitive development.

These students may have specific emotional characteristics/conditions such as anxiety disorder, mood disorder, oppositional defiant disorder, conduct disorder, and schizophrenia. Not addressing any one of these disorders with the appropriate support system could have potentially tragic results. Behavioral characteristics of an emotional disorder include externalizing behavior and conversely internalizing behavior. The former can result in problem behavior and physical aggression while the latter results in depression and anxiety. Finally, students with emotional disorders have a number of academic issues as well, and each year half of the students in this category drop out of school entirely.

One intriguing possible contributing factor to emotional disturbance can be found in deficits in communication. An estimated 71% of students with emotional disorders also have expressive and receptive language disorders that impact their ability to understand and communicate with peers and adults.

Impact on Learning

Students with emotional disorders can be found at every level of cognitive functioning, but the majority of these students tend to have low average intelligence. Most achieve below grade level in academic achievement, with the greatest deficits in both math and spelling. Many have a coexisting learning disability of some type. Students that exhibit externalizing behaviors are at the greatest risk for continued deficits in academic functioning. Students with emotional disorders are less likely to attend post-secondary school than students in many other disability categories. An effective educational program for students with emotional disorders will provide emotional and behavioral supports that foster the replacement of problem behaviors with more appropriate behaviors. Positive behavior support systems are one especially effective strategy to achieve this goal, as are the implementation of wraparound services.

Teaching Strategies

Wraparound planning is a collaborative process that has shown great promise in supporting students with emotional disorders, both in research and in more practical application. This planning process brings all of the involved service providers (i.e., adult rehabilitation services, mental health services, guidance counselor) and individuals together to create a natural support system that is founded on the strengths of the individual student and the community in which that student lives. The family is an integral part of this process, and the overall goal is to devise a program that will capitalize on the strengths and interests of the student while utilizing community resources for placement and intervention.

Generally, academic achievement and problem behaviors often go hand-in-hand for students with emotional disorders. To put this another way, the more difficulty they have with a classroom task, the more likely that maladaptive behavior will result. Supporting the academic performance of these students will thus have the added benefit of decreasing externalizing and internalizing behaviors. Best practices for students with emotional disorders are often best practices for all students. A strategy such as allowing students to choose between classroom tasks, for example, is an effective way to decrease problem behaviors in general. Consistent and specific praise is also a great technique to utilize with all students in the classroom, but can be particularly effective with students with emotional disorders.

It is very important to not make assumptions about any family of a child with an emotional disorder. Many emotional disorders have an organic cause, and the parents of the child may well be loving and supportive in every way. However, some of these students have indeed been abused in some fashion in their young lives, and this too can be a cause of emotional or behavioral issues. Trust can be a very large issue for these children. Forming a relationship with these students that is built on empathy, trust, and mutual respect can often be the solution to many problem behaviors, and can have a lasting impact of the emotional development of the child.

Assistive Technology

Some modification in instruction will be necessary to allow a student with an emotional disorder to demonstrate mastery in a number of academic areas, and most especially in the area of writing. Word processing software can be an excellent supplementary aid for these students, allowing them to edit and revise their work as they produce it. These programs can strengthen spelling skills and writing cohesion simply by making the writing process easier overall. Of particular benefit are word processing programs that read the text as it is typed, providing an additional audio cue for the student.

Organizations

There are a number of excellent organizations that can help support classroom instruction for students with emotional and behavioral disabilities. The information presented in this module is intended as just a very brief description of emotional disorder and its impact on learning. Much more in-depth information and instructional strategies can be accessed through the following organizations:

American Academy of Child and Adolescent Psychiatry

The AACAP (American Academy of Child and Adolescent Psychiatry) is the leading national professional medical association dedicated to treating and improving the quality of life for children, adolescents, and families affected by these disorders. Composed of over 7,500 child and adolescent psychiatrists and other interested physicians, its members actively research, evaluate, diagnose, and treat psychiatric disorders and pride themselves on giving direction to and responding quickly to new developments in addressing the health care needs of children and their families.

Public Information Office
3615 Wisconsin Ave., NW
Washington, DC 20016-3007

Web: www.aacap.org

Center on Positive Behavioral Interventions and Supports

The OSEP-funded National Technical Assistance Center on Positive Behavior and Intervention Supports was established to address the behavioral and discipline systems needed for successful learning and social development of students. The Center provides capacity-building information and technical support about behavioral systems to assist states and districts in the design of effective schools.

5262 University of Oregon
Eugene, OR 97403-5262

Email: pbis@oregon.uregon.edu
Web: www.pbis.org

Center for Disability and Development

Dept. of Educational Psychology
4225 Texas A&M University
College Station, TX 77843-4225

Council for Exceptional Children

The Council for Exceptional Children (CEC) is the largest international professional organization dedicated to improving educational outcomes for individuals with exceptionalities, students with disabilities, and/or the gifted. CEC advocates for appropriate governmental policies, sets professional standards, provides continual professional development, advocates for newly and historically underserved individuals with exceptionalities, and helps professionals obtain conditions and resources necessary for effective professional practice.

1110 North Glebe Road, Suite 300
Arlington, VA 22201-5704

Federation of Families for Children's Mental Health

This organization is dedicated exclusively to helping children with mental health needs and their families achieve a better quality of life. They provide leadership to develop and sustain a nationwide network of family-run organizations; focus the passion and cultural diversity of our membership to be a potent force for changing how systems respond to children with mental health needs and their families; help policy-makers, agencies, and providers become more effective in delivering services and supports that foster healthy emotional development for all children.

1101 King Street, Suite 420
Alexandria, VA 22314

Email: ffcmh@ffcmh.org
Web: www.ffcmh.org

National Alliance for the Mentally Ill (NAMI)

NAMI is the National Alliance on Mental Illness, the nation's largest grassroots organization for people with mental illness and their families. NAMI is dedicated to the eradication of mental illnesses and to the improvement of the quality of life for persons of all ages who are affected by mental illnesses. NAMI members and friends work to fulfill our mission by providing support, education, and advocacy.

Colonial Place Three
2107 Wilson Boulevard, Suite 300
Arlington, VA 22203-3754

Web: www.nami.org

Mental Health America

Mental Health America is dedicated to helping ALL people live mentally healthier lives. They work to fulfill this mission by education the public about ways to preserve and strengthen mental health; advocating for access to effective care; fostering innovation in research, practice, services and policy; and providing support to individuals and families.

2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311

Web: www.nmha.org

National Mental Health Information Center

The National Mental Health Information Center was developed for users of mental health services and their families, the general public, policy makers, providers, and the media. They provide free information about mental health via a toll-free number, their website, and more than 600 publications.

P.O. Box 42557
Washington, DC 20015

Web: www.mentalhealth.org

References

Hunt, N., and Marshall, K. (2006). Exceptional children and youth. Boston, MA: Houghton Mifflin Company.

National Dissemination Center for Children with Disabilities (2004). Fact Sheet 5. Retrieved February 1, 2008 from www.nichcy.org/pubs/factshe/fs5txt.htm.

Turnbull, A., Turnbull, R. & Wehmeyer, M. L. (2007). Exceptional lives. Special education in today's schools. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

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Students with emotional disorders typically have a hard time maintaining relationships, and these personal problems may lead to physical symptoms in time.

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Emotional & Behaviorally Disturbed Students (EBD)

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The Center for Treatment of Anxiety and Mood Disorders

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Posted by

There is a plethora of information out there regarding mood disorders of all kinds. The public is becoming more and more educated about panic disorder, generalized anxiety disorder, bipolar mood disorder, and the like. But what many people still do not realize is that these disorders are not limited to adults.

A child may experience similar mood disorders, as well. In fact, 7-14% of children will experience an episode of major depression before the age of 15. Out of 100,000 adolescents, two to three thousand will have mood disorders, out of which 8-10 will commit suicide. It is for this reason that the symptoms of mood disorders in children should attract special attention.

Symptoms of mood disorders in children include:

Sadness

Fatigue

Despair

Dejection

Changes in appetite

Loss of interest

Difficulty sleeping

Hopelessness

Sense of inferiority

Exaggerated guilt

Feelings of incompetence

Inability to function effectively

Many children might have one or two of these symptoms at one time or another but it is the presence of several symptoms for an extended period that indicates a mood disorder. There are three levels of mood disorder in children:

Severe depression is present when the child has nearly all the symptoms and these symptoms almost always keep them from performing day to day activities.

Moderate depression occurs when a person has many symptoms that often limit their regular activities.

Mild depression is present when a child has some of the symptoms and it requires extra effort for them to do every day things.

If you or someone you know has a child who might be suffering from a mood disorder, it is important to seek help immediately. The mood disorder will be diagnosed through extensive interviews with the child and his or her caregivers. If a mood disorder is found, it is often treated through medication, psychotherapy, or a combination of the two.

For more information about Mood Disorders in children , diagnostic steps, and therapy for the condition in the Delray Beach, Florida area, contact The Center for Treatment of Anxiety Disorders at 561-496-1094 or email them today.

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Mood Disorders in Children - The Center for Treatment of Anxiety and Mood Disorders

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Posted by There is a plethora of information out there regarding mood disorders of all kinds. The public is becoming more and more educated about panic disorder, generalized anxiety disorder, bipolar mood disorder, and the like. But what many people still do not realize is that these disorders are not limited to adults.

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A mood disorder, also referred to as an affective disorder, is a condition that severely impacts your mood and its related functions. Mood disorder is a broad term that's used to include all the different types of depressive and bipolar disorders, both of which affect your mood. If you have symptoms of a mood disorder, your moods may range from extremely low ( depressed) to extremely high or irritable (manic).

Types of Mood Disorders

With the most recent update of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in 2013, mood disorders are now separated into bipolar disorder and related disorders and depressive disorders.

In general, the main types of mood disorders include:

Major depressive disorder: This is what we often hear referred to as major depression or clinical depression. It involves periods of extreme sadness, hopelessness, or emptiness accompanied by a variety of physical, cognitive, and emotional symptoms.

Bipolar I disorder: Also referred to in the past as "manic depression," if you have mania, you experience euphoric and/or irritable moods and increased energy or activity. During manic episodes, you also regularly engage yourself in activities that can very result in painful consequences for you and/or someone else.

Bipolar II disorder: For diagnosis, you must have had at least one episode of current or past hypomania, which is a less severe form of mania, and at least one episode of current or past major depression, but no history of any manic episodes. The criteria for episodes of mania, hypomania, and major depression remain the same.

Cyclothymic disorder:Diagnosis requires a two-year history minimum of many episodes of not-quite hypomania and not-quite major depression.

Other: There are other categories of mood disorders that include substance/medication and medically induced mood disorders. There are also the diagnosis of "other specified" and "unspecified" mood disorders that don't exactly meet criteria for the other mood disorders.

New Mood Disorders

There are three new depressive disorders included in the DSM-V, including:

Disruptive mood dysregulation disorder: This depressive disorder was added to the DSM-Vfor children up to 18 years of age who exhibit persistent irritability and anger and frequent episodes of extreme temper outbursts without any significant provocation.

Persistent depressive disorder: This diagnosis is meant to include both chronic major depressive disorder that has lasted for two or more years and what was previously known as dysthymic disorder or dysthymia, a lower grade form of depression.

Premenstrual dysphoric disorder: This diagnosis is based on the presence of specific symptoms in the week before the onset of menstruation, followed by the resolution of these symptoms after onset. The symptoms must include one or more of the following: mood swings, irritability or anger, depressed mood or hopelessness, and anxiety or tension, as well as one or more of an additional seven symptoms, with a total of at least five symptoms.

Mood disorders can lead to difficulty in keeping up with the daily tasks and demands of life. Some people, especially children, may have physical symptoms of depression, like unexplained headaches or stomachaches. Because there are various types of mood disorders, they can have very different effects on your life.

In general, symptoms may include:

Loss of interest in activities you once enjoyed

Eating more or less than usual

Difficulty sleeping or sleeping more than usual

Fatigue

Crying

Anxiety

Feeling "flat," like you just don't have the energy to care

Feeling isolated, sad, hopeless, and worthless

Difficulty concentrating

Problems making decisions

Feelings of guilt

Irritability

Thoughts of dying and/or suicide

With mood disorders, these symptoms are ongoing and eventually start to affect your daily life in a negative way. They're not the sporadic thoughts and feelings that everyone has on occasion.

No one knows the exact causes of mood disorders, but a variety of factors seem to contribute to them and they tend to run in families. Chemical imbalances in your brain are the most likely cause. Stressful life events like death, divorce, or trauma can also trigger depression, especially if you've already had it before or there's a genetic component.

Mood disorders should be properly evaluated and treated by a mental health professional, such as a psychiatrist. If any of the symptoms above have been interfering with your life, particularly if you are having suicidal thoughts, you should seek help immediately.

Your doctor will be able to diagnose you by performing a physical exam and lab tests to rule out any physical reasons for your symptoms, as well as a psychiatric evaluation.

Millions of people experience mood disorders and are successfully treated, helping them live a better quality of life. Treatments for mood disorders can include psychotherapy, also known as talk therapy, as well as medications to help regulate the chemical imbalances in your brain. A combination of psychotherapy and medication is often the best course of action to get you on the road to feeling better.

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Mood Disorders Classifications According to the DSM-V

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A mood disorder, also referred to as an affective disorder, is a condition that severely impacts your mood and its related functions. Mood disorder is a broad term that's used to include all the different types of depressive and bipolar disorders, both of which affect your mood.

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Overwhelmed by classwork? Scared because your parents are splitting up? Worried about a friend? Feel like you don't fit in?

Sometimes it's just not possible to sort through tough times alone. Problems can build up and you may lose sleep, find you can't concentrate on homework, or even become depressed. When you need to talk to someone, your school counselor (sometimes called a guidance counselor) can be a great place to start.

Counselors Help You Cope

School counselors know how to listen and help. They'll take your problem seriously and work with you to find a good solution. School counselors are trained to help with everything - and it doesn't have to be just school stuff. A counselor can help you deal with the sadness when someone has died as well as advise you on taking the right classes to get into your dream college.

It takes a lot of training to be a school counselor. Most not only have college degrees but also master's degrees, as well as special training and certification in counseling. One of the many good things about school counselors is that they are up-to-date on all the top things that affect students, including any trends that might affect your school.

School counselors can give you all sorts of tips and support on solving problems and making good decisions. Chances are that whatever problem you have, your counselor has seen it before - and has lots of good advice on how to help you work through it. Counselors can give you tips on standing up for yourself if you're being bullied, managing stress, talking to your parents, and dealing with anger and other difficult moods. Counselors also can advise you on problems you may have with a teacher, such as communication difficulties or questions over grades.

School counselors are plugged in to the rest of the school community and, in many cases, the outside community as well. So they can refer students to outside resources like substance abuse treatment centers, professional therapists, and even health clinics.

It can help to know the different types of support your counselor offers - even if you don't think you need it now. Some schools and school districts use their websites to explain what the counselor does and how to get a counseling appointment. You may find their services listed under headings like "student resources," "student services," or "student counseling."

Your school's website may also explain the roles of other school staff members who can help students with problems or school issues. Depending on the size of your school, these people may include school psychologists, tutors, college or career counselors, and school nurses.

The counselor's role varies from school to school and district to district, so don't assume your counselor provides the same services as the counselor in a friend's school.

How Do I See the Counselor?

You may have been assigned a counselor when you started the school year. Or your school may leave it up to you to go to the counseling office on your own. A counselor might also visit your class to talk about certain subjects and let you know when he or she is available. In some schools, teachers or school nurses refer students to counselors if they think there's something the student needs to work through. Different schools have different policies on putting students in touch with counselors.

Your school's website, administrator's office, or a trusted teacher can also tell you how to contact the counselor for an appointment. In many schools, there's a guidance secretary who coordinates appointments. Many counselors are willing to meet with students at times that fit into the student's schedule - such as before or after school or during lunch.

It's probably a good idea to visit your counselor and get to know him or her even if you don't have a problem. This helps you feel comfortable with the counselor in case you ever do need to meet in a time of crisis. It's usually easier to talk about a tough issue or a problem when you already feel comfortable with the counselor. Meeting your counselor when you're not in the middle of a crisis also gives you a chance to discuss such issues as what the counselor will keep confidential and how he or she works with a student to resolve a problem.

Student-Counselor Meetings

Counselors meet with students individually or in small groups. The most common setting for most students is a private meeting just between the student and the counselor. Most school counselors have offices where you can sit down and talk.

You don't need to know exactly what's bothering you when you talk with the school counselor. It's perfectly OK just to make an appointment because you're feeling bad or not doing as well in school as you'd like. It's the school counselor's job to help people figure out what's going on. In fact, it's often better to see your counselor as soon as you know something's up, even if you don't know what the trouble is. Chances are you'll be able to solve a problem faster when you have the skill and resources of the counselor behind you.

How often you meet with your counselor depends on the issue. Some concerns are dealt with in a one-time meeting. Others require regular meetings for a while. It all depends on the topic at hand and the plan that you and your counselor decide on.

Counselors also sometimes meet students in groups. Group meetings can really help people who are dealing with similar issues, such as a divorce. In these group settings, people can share their feelings and learn coping skills. Not only do you get great ideas in a group setting, but it can also help to know that other students are going through the same thing and that they understand.

Counselors often come into the classroom, too, to teach a class on a subject that affects everyone, such as good study skills.

Sometimes the counselor might meet with you and a teacher or you and a parent - especially if the teacher or your parent has asked for the meeting.

How Confidential Is It?

When you meet privately with a school counselor, your conversation will most likely be confidential. The counselor isn't going to go blabbing your business around school. Different schools have different policies, though. So talk directly with your counselor about what he or she considers confidential.

In very rare cases, a counselor is unable to keep information confidential. A counselor who thinks that someone is at risk of being harmed is required by law to share that information. Even in these rare cases, the counselor will share that information only with the people who need to know.

People sometimes worry that other students will think they're seeing the counselor because they have major problems or they're in trouble. But in most schools the counselor deals with lots of school issues - as well as personal ones. So you could be meeting to get career counseling or advice on which classes to take for college. Your friends and classmates don't need to know why you're seeing the counselor unless you choose to tell them.

Your school counselor is someone who is separate from your life - a neutral adult who isn't a parent, relative, or teacher. Your school counselor isn't a therapist. (So if you see your counselor, it's not the same as getting therapy.) If you need help in some way that the school counselor can't provide, he or she can give you information about other resources, such as the name of a therapist.

No matter what your problem, try to think of the counselor as someone who's on your side. Even if you've had a bad experience in the past with another counselor or a private therapist, don't hesitate to contact your school counselor - or talk to the counseling office about seeing someone else if you don't click with your current counselor. Every counselor is different, and most understand that it's natural for people to be more comfortable with some individuals than others.

Don't be surprised if your parents know your school counselor. They may even be in touch with each other. Sometimes counselors offer workshops for parents, with or without their kids, about topics such as study skills or preventing drug abuse. It's good for the counselor and your parents to know each other when everything is going OK. That way, if any problems come up - like if you're being bullied or there's a death in the family and you have to be out of school - they'll be able to work together comfortably.

If you're seeing your counselor and your parents don't know about it, don't worry that the counselor will talk to them about your meetings. Unless you've given the counselor the feeling that you may harm yourself or others, what's said in your meetings will stay just between you and the counselor.

School counselors are all about helping to make your school experience the best it can be. The role of the school counselor today is very different from what it was like when your parents were in school. Instead of just focusing on schoolwork and careers, today's counselors are there for students in a broader way. They help students handle almost any problem that might get in the way of learning, guide students to productive futures, and try to create a positive environment for everyone at school. So if you need a counselor's advice, just ask!/p>

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Overwhelmed by classwork? Scared because your parents are splitting up? Worried about a friend? Feel like you don't fit in? Sometimes it's just not possible to sort through tough times alone. Problems can build up and you may lose sleep, find you can't concentrate on homework, or even become depressed.

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Depression can be an isolating illness. Despite progress in knowledge, stigma reduction, and treatment options, it is not uncommon for someone struggling with depression-or that person's family and friends-to feel alone. The goal of this blog series is to break through that isolation and connect the various people who play a role in any person's depression: the person themselves, a parent or caregiver, a school counselor, a clinician, and individuals who work in policy and advocacy. Though these specific individuals can only share their own journeys, each story is part of a larger narrative that illuminates what the entire worlds of depression and treatment can look like. The ultimate goal of this project is to share individual stories with a larger audience and to allow each stakeholder the chance to give advice to those who occupy different spaces in the journey and struggle of depression. Each interviewee was given the choice to have their story told with their name or to remain anonymous. Those who remain anonymous have chosen to do so in order to protect the confidentiality of their friends and family whose lives intertwine with their struggles. In those cases, the interviewee's name will be replaced with a random initial.
We welcome your thoughts and comments in our comment section! And, of course, thank you so very much to all of the brave individuals who so generously and vulnerably shared their stories with us.

Karen is a school counselor and is one of the staff sponsors for the Erika's Lighthouse Teen Club at Evanston Township High School (ETHS) in Evanston, IL. She first interacted with depression personally. She says that she always struggled with depression, but because people didn't talk about it, it was written off as the moodiness that comes with "being a girl." Karen was in a bad car accident that caused a brain injury which she believes triggered her depression. Without conversations and resources, Karen struggled for a long time and has worked hard to get a place where she can use her experiences to help others. It's a set of experiences she says she would never wish on anyone, but it has made her better at her job and has given her an important level of understanding.

Karen was a Physical Education teacher for quite a while and says that during that time she was moved by the vulnerability she saw in her students. She says she saw them "at their most raw" when they were asked to do things like swim in front of their peers or come together to support each other through tough team building challenges. Karen also led health class and spent time teaching her students about mental health. She feels, she says, like she had always been a counselor. She just needed a degree to back up that expertise and experience, so she went back to get a Master's degree in counseling.

Now, she is immersed in the world of mental health every day when she helps her students and their parents deal with what it means to need therapy, medication, and/or hospitalization. Though she does not always choose to disclose her own struggles, she is open about the fact that she has depression and lets the knowledge she has gained through the years guide and inform the students and parents with whom she works. Her role here varies based on the student and the situation, but she always aims to be open, caring, and easy to talk to. Sometimes, this means riding with a student in an ambulance if they have to be hospitalized; sometimes it is about letting students sit in her office to do school work if a typical classroom setting is too overwhelming; other times, it is about advocating for a student's right to mental health care and explaining the necessity to parents who are reluctant to access help. Karen's support can also just mean listening and empathizing with her students that depression is really, really hard, with both good days and bad days, but that one day at a time, students can get better.

The same way that a good therapist meets her client where they are, it is important to meet parents where they are in their understanding of mental health and working with them to help their children and provide information. However, because there is student confidentiality, it takes a lot of patience and care to navigate that boundary. This also means understanding the cultural norms and concerns of a student and their parents so that Karen can help the student engage in that conversation in a way which is effective for the student and helpful for their parents.

At ETHS, there is a movement towards more coordinated care within the high school which means that there are more resources in place to help students who need help or who are returning from in-patient treatment. There is now a clinician whose job it is to help students re-enter into the high school after being hospitalized; Karen calls this role an unfortunate necessity which is at the forefront of changing the ways in which the school can play an active role in the care of students struggling with mental illness. For students at ETHS who have been hospitalized, there is a full re-entry plan that is created and instituted by the hospital and the school. This means figuring out what information teachers are going to be given and if students want to create a signal for times when they might need to leave the room and access supports within the school. ETHS has a "red pass" procedure in place, where students can use their pass to visit the nurse, counselors, or social workers if they need a break from class.

Though disclosure is always up to the student, Karen feels like the more information teachers and other supportive adults in the building have, the more safeguards can be put in place to keep students happy and safe. By creating a safe school environment, students who need extra support can still access their education. Karen also discussed the process of getting official paperwork in place that formalize accommodations for students. She often has to help parents navigate the forms and figure out what kinds of choices will be best for their children. This coordinated care also means that the mental health professionals can all work together to provide the best possible service, instead of relegating some tasks to the social workers and others to the counselors.

Mental health, Karen says, is a priority of ETHS and of the community at large. Wellness is one of the school's major goals both for students and for faculty and staff. She has found wellness for herself-a process she actively engages in every day-and has been transformative both to ETHS and to the Erika's Lighthouse Teen Club there in breaking down stigma, advocating for students, and showing that a life with depression can still include a lot of compassion and caring.
What Karen wants you to know...
What should a young adult/child know? Recognize that what you are going through is tough and your feelings about your experience are valid; you might have a bad time and good time within five minutes of one another and that's okay. You are not alone: there are people here who want to be there for you and help you.

What would you want a parent to know? You can be a model of strength and empowerment for your children-they can see how to advocate for themselves and how to be there for another person selflessly and without judgment. Trust your child, be willing to hear what they need to tell you, and know that even if your child takes a step back know that you can move forward again.

What would you want another school counselor/social worker to know? We all took this job because we want to make a difference in the lives of the students we work with; sometimes this means thinking out-of-the-box to figure out what one specific student needs. Be open and empowering unconditionally.

What would you want a doctor/therapist/clinician to know? Find ways to push your clients safely. If you've been to a lot of therapists, you know how to be a client and move through therapy without digging too deeply into what is happening internally so you need to know how to help examine those things that need to be talked about but are easy to avoid.

What would you want a policy maker/advocate to know? Try to find ways to understand individual needs as they relate to policy. Also, make mental health care a part of more insurance policies so that people can access the care that they need with a therapist they connect to and can afford.

Story #4 of this blog series will be posted in a few short weeks! For more depression resources for schools, visit the school section of our website.

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5 Perspectives On Teen Depression: A School Counselor's Story - Erika's Lighthouse

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aren is a school counselor and is one of the staff sponsors for the Erika's Lighthouse Teen Club at Evanston Township High School (ETHS) in Evanston, IL. She first interacted with depression personally. She says that she always struggled with depression, but because people didn't talk about it,

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ConductDisorders - A soft place to land for battle weary parents.

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Recommended Book List *
The following books are just a few of the most recommended by members of our board.
by Gregory Bodenhamer
"Back in Control is based on a highly successful program that has helped thousands of parents regain control over their children. Without compromising your values away or kicking the kids out of the house, it offers you the simplest, most effective method of childhood discipline to date. It presents a three-step formula that is perfect for virtually any adult wanting to control children's misbehavior. Instead of getting caught up in children's arguments and manipulations, Back in Control shows parents how to reestablish their rightful place as bosses of the family." Gregory Bodenhamer worked as a juvenile probation officer for more than eight years and supervised some of southern California's worst behaved children. Along with his associate Darlyne Pettinicchio, he created the Back in Control Program to teach parents, teachers, school administrators, probation officers, social workers, and others how to control children's misbehavior. He is also the author of Parent in Control.
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Before It's Too Late by Stanton E. Samenow, Ph.D.
"While typical children go through a phase with occasional flashes of misconduct, it's imperative that parents recognize as early as possible the special behavior of the habitually secretive and antisocial child. Dr. Samenow identifies the seven common traits of antisocial children and refutes the common belief that they don't know right from wrong. In fact, says Dr. Samenow, they know the difference very well, but choose to believe that rules don't apply to them. Parents must learn how to help these kids accept responsibility for their actions." Dr. Samenow is also the author of Inside the Criminal Mind and collaborated with Dr. Samuel Yochelson on the three-volume work The Criminal Personality. He has served on three presidential task forces on crime and drug issues and has a private practice in Alexandria, Virginia.

The Bipolar Child by Demitri Papolos, M.D., and Janice Papolos
"Bipolar disorder-manic depression-was once thought to be rare in children. Now researchers are discovering that not only can bipolar disorder begin very early in life, but also that it is much more common than ever imagined. Yet the illness is often misdiagnosed or overlooked. Why? Bipolar disorder manifests itself differently in children than in adults, and in children there is an overlap of symptoms with other childhood psychiatric disorders. As a result, these kids may be given any number of psychaitric labels: 'ADHD, Depressed, Oppositional Defiant Disorder, Obsessive-Compulsive Disorder, or Separation Anxiety Disorder.' Too often they are treated with stimulants or antidepressants-medications that can actually worsen the bipolar condition. Included in these pages is the first Individual Education Plan-IEP-ever published for a bipolar child." Demitri Papolos, M.D., is an associate professor of psychiatry at Albert Einstein College of Medicine in New York City. He is the medical advisor for Parents of Bipolar Children, an on-line support group, and the chair of the professional advisory board of the Child and Adolescent Bipolar Foundation. Dr. Papolos and Janice Papolos have also written the book Overcoming Depression.

The Defiant Child by Douglas A. Riley
"As children explore the world around them, nearly all will occasionally test boundaries and challenge authority. But some children and teenagers continually defy attempts to control their behavior, seemingly rejecting authority altogether. Consistently disrputive in school and chronically in trouble at home, these kids leave countless parents feeling frustrated and hopeless. By explaining how oppositional children and adolescents view the world, Dr, Riley first helps parents make sense of their child's often upsetting behavior and then teaches them proven methods for modifying it. Whether your child is simply going through a 'rebellious phase' or has been diagnosed with full blown O.D.D., The Defiant Child can help you take control of the chaos and restore peace to your family." Dr. Riley specializes in child and adolescent psychology and operates a private outpatient clinic in Newport News, Virginia. Dr. Riley teaches parenting classes, gives presentations to school groups, and conducts workshops for court workers who deal with oppositional children. He is also the author of The Depressed Child.

The Explosive Child by Ross W. Greene, Ph.D.
"Dr. Ross Greene makes a compassionate argument that the difficulties of these children stem form developmental deficits in two critical skills: flexibility and frustration tolerance. He asserts that if such children could do well, they would. Dr. Greene describes the factors that contribute to 'inflexible-explosive' behavior in children and why the strategies that work for most children aren't as effective for inflexible-explosive children." Dr. Greene is Director of Cognitive-Behavioral Psychology at the Clinical and Research Program in Pediatric Psychopharmacology at Massachusettes General Hospital where he specializes in the treatment of inflexible, easily frustrated, explosive children and adolescents, and their families. He is also Assistant Professor of Pychology in the Department of Psychiatry at Harvard Medical School. Dr. Greene presents Explosive Child Workshops based on his book throughout the country.

1-2-3 Magic by Thomas W. Phelan Ph.D.
"1-2-3 Magic addresses the difficult task of child discipline with humor, keen insight and proven experience. This time-tested program provides easy-to-follow steps for disciplining children aged 2-12 without yelling, arguing or spanking. You'll also learn when--and how--your silence can speak louder than you think." Dr, Phelan is a registered Ph.D. Clinical Psychologist who founded the Illinois Association for Hyperactivity and Attention Deficit Disorder. He is also the author of Surviving Your Adolescents and All About Attention Deficit Disorder.

Straight Talk About Psychiatric Medications for Kids by Timothy E. Wilens, M.D.
"As a parent, deciding whether to allow your child to take medication for an emotional or behavioral problem may be one of the toughest choices you will ever face. This essential book provides the up-to-date information that will enable you to fully understand what your doctor is recommending and what your options are." Dr. Wilens is an Associate Professor of Psychiatry at Harvard Medical Scool and specializes in pediatric and aduly psychopharmacology in his clinical work at Massachusetts General Hospital.

Your Defiant Child by Russell A. Barkley, Ph.D.
"Every child has 'ornery' moments, but more than 1 in 20 American children exhibit behavioral problems that are out of control. Drawing on Dr. Russell A. Barkley's many years of work with parents and children, the book clearly explains what causes defiance, when it becomes a problem, and how it can be resolved. Its comprehensive eight-step program emphasizes consistency and cooperation, promoting changes through a system of praise, rewards, and mild punishemnt." Dr. Barkley is Director of Psychology and Professor of Psychiatry and Neurology at the University of Massachusetts Medical Center in Worchester, Massachusetts. He has also written the book Taking Charge of ADHD.

*All quotes were taken directly from the book jackets of their respective books.

Please note that this is a draft version, still have more books to add.

The Out of Sync Child by Carol Stock Kranowitz

The Out-of-Sync Child broke new ground by identifying Sensory Processing Disorder, a common but frequently misdiagnosed problem in which the central nervous system misinterprets messages from the senses. This newly revised edition features additional information from recent research on vision and hearing deficits, motor skill problems, nutrition and picky eaters, ADHA, autism, and other related disorders.

The Out of Sync Child Has Fun by Carol Stock Kranowitz

This companion volume to The Out-of-Sync Child presents activities that parents of kids with Sensory Integration Dysfunction can do at home with their child to strengthen their child's abilities-and have some fun together along the way.

Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder by by Paul T. Mason , Randi Kreger

Do you feel manipulated, controlled, or lied to? Are you the focus of intense, violent, and irrational rages? Do you feel you are 'walking on eggshells' to avoid the next confrontation?

If the answer is 'yes,' someone you care about may have borderline personality disorder (Borderline (BPD)). Stop Walking on Eggshells has already helped nearly half a million people with friends and family members suffering from Borderline (BPD) understand this destructive disorder, set boundaries, and help their loved ones stop relying on dangerous Borderline (BPD) behaviors. This fully revised edition has been updated with the very latest Borderline (BPD) research and includes coping and communication skills you can use to stabilize your relationship with the Borderline (BPD) sufferer in your life.

This compassionate guide will enable you to:

Make sense out of the chaos

Stand up for yourself and assert your needs

Defuse arguments and conflicts

Protect yourself and others from violent behavior

Parenting With Love And Logic by Foster Cline & Jim Fay
Psychiatrist Cline and educator Fay's "Love and Logic" parenting method advocates raising responsible children through practice. "Helicopter" parents hover around their children while "drill sergeant" parents give orders to theirs, they claim. Neither of these styles permits children to learn how to make choices and learn from the consequences. The result is that as early as adolescence these children too often make bad decisions. In the context of a healthy, loving relationship, "Love and Logic" parents teach their children responsibility and the logic of life by solving their own problems, providing skills for coping in the real world. After laying out the principles of "Love and Logic," the authors provide "parenting pearls," which are strategies for applying the method to actual situations such as back-seat battles in the car, homework, and keeping bedrooms clean.

Parenting Teens With Love And Logic by Foster Cline & Jim Fay

Parents need help to teach their teens how to make decisions responsibly--and do so without going crazy or damaging the relationship.

Parenting Teens with Love and Logic, from the duo who wrote Parenting with Love and Logic, empowers parents with the skills necessary to set limits, teach important skills, and encourage decision-making in their teenagers.

Covering a wide range of real-life issues teens face--including divorce, ADD, addiction, and sex--this book gives you the tools to help your teens find their identity and grow in maturity.

Indexed for easy reference.

When Our Grown Kids Disappoint Us: Letting Go of Their Problems, Loving Them Anyway, and Getting on with Our Lives by Jane Adams

How do today's parents cope when the dreams we had for our children clash with reality? What can we do for our twenty- and even thirty-somethings who can't seem to grow up? How can we help our depressed, dependent, or addicted adult children, the ones who can't get their lives started, who are just marking time or even doing it? What's the right strategy when our smart, capable "adultolescents" won't leave home or come boomeranging back? Who can we turn to when the kids aren't all right and we, their parents, are frightened, frustrated, resentful, embarrassed, and especially, disappointed?

In this groundbreaking book, a social psychologist who's been chronicling the lives of American families for over two decades confronts our deepest concerns, including our silence and self-imposed sense of isolation, when our grown kids have failed to thrive. She listens to a generation that "did everything right" and expected its children to grow into happy, healthy, successful adults. But they haven't, at least, not yet -- and meanwhile, we're letting their problems threaten our health, marriages, security, freedom, careers or retirement, and other family relationships.

With warmth, empathy, and perspective, Dr. Adams offers a positive, life-affirming message to parents who are still trying to "fix" their adult children -- Stop! She shows us how to separate from their problems without separating from them, and how to be a positive force in their lives while getting on with our own. As we navigate this critical passage in our second adulthood and their first, the bestselling author of I'm Still Your Mother reminds us that the pleasures and possibilities of postparenthood should not depend on how our kids turn out, but on how we do!

Yes, Your Teen is Crazy!: Loving Your Kid Without Losing Your Mind - by Michael J. Bradley

For parents who have tried everything but still have teens who are out of control, Bradley's Yes, Your Teen Is Crazy! is a funny, blunt, and reassuring book. Philadelphia psychologist Bradley approaches the subject from the viewpoint that teens are, well, a little nuts; using current brain research, he points out that the most sophisticated parts of the mind are not developed until the end of adolescence ergo, the acting out, mood swings, ADHD, depression, suicide, anorexia, etc. The basic premise is that parents are still the most influential force in their kids' lives and that the old rules of parenting are not only unhelpful but destructive. Adults must take the blame for ignoring rampant alcohol addictions among teens, allowing sex to saturate culture so much that kids don't even know what intimacy and commitment are, and believing that raising children in 2001 can be easy. Rejecting peer pressure as an excuse for unacceptable behaviors, Bradley distinguishes between "normal" and "insane." One chapter describes negotiation, decision-making, and the enforcement of rules; another deals with the new phenomenon of teen rage and how to survive it. Overall, the message is that kids can become fine people even if they screw up a lot, and you need to play the parent, not the cool confidante.

Setting Boundaries(TM) with Your Adult Children: Six Steps to Hope and Healing for Struggling Parents by Allison Bottke

This important and compassionate new book from the creator of the successful God Allows U-Turns series will help parents and grandparents of the many adult children who continue to make life painful for their loved ones.

Writing from firsthand experience, Allison identifies the lies that kept her, and ultimately her son in bondage&#8212;and how she overcame them. Additional real life stories from other parents are woven through the text.

A tough&#8211;love book to help readers cope with dysfunctional adult children, Setting Boundaries with Your Adult Children will empower families by offering hope and healing through S.A.N.I.T.Y.&#8212;a six&#8211;step program to help parents regain control in their homes and in their lives.

S = STOP Enabling, STOP Blaming Yourself, and STOP the Flow of Money
A = Assemble a Support Group
N = Nip Excuses in the Bud
I = Implement Rules/Boundaries
T = Trust Your Instincts
Y = Yield Everything to God

Lost at School: Why Our Kids with Behavioral Challenges are Falling Through the Cracks and How We Can Help Them by Ross Greene

Psychiatrist and Harvard professor Greene follows up The Explosive Child with an in-depth approach to aid parents and teachers to work together with behaviorally challenging students. Greene's philosophy is driven by the recognition that "kids who haven't responded to natural consequences don't need more consequences, they need adults who are knowledgeable about how challenging kids come to be challenging." Greene's "Plan B" system, which is fully and clearly explained in the course of the book, emphasizes identifying challenging behaviors-acting out, hitting, swearing, poor performance in class-and then working with students to find actual, practical ways to avoid them. Helpfully, Greene uses a fictional school for examples, devoting several pages to illustrative anecdotes in each chapter, greatly increasing the material's accessibility. Greene's technique is not fail-proof, principally because it requires the good will and hard work of all participants; a section on implementing Plan B in the face of real disagreement or apathy would have been helpful. However, Plan B has all the qualities of accessibility, logic and compassion to make it a solid strategy for parents and educators.

There's also "Raising your Spirited Child" - don't know the author off-hand, but it's perspective is one of understanding "intense" kids - not necessarily diagnosis kids, but outside the norm - and ideas of how to work with areas of intensity... pretty useful info even for diagnosis kids! Practical advice.

Unwritten Rules of Social Relationships, Decoding Social Mysteries Through the Unique Perspectives of Autism, by Temple Grandin, PhD

The Manipulative Child, How to Regain Control and Raise Resilient, Resourceful, and Independent Kids, by E.W. Swihart Jr., MD and Patrick Cotter, PhD

Autism Spectrum Disorders, by Chantal Sicile-Kira

Asperger's Syndrome, by Tony Attwood

The Everything Parent's Guide to Children With Asperger's Syndrome, by William Stillman

These are some books that my child's therapist gave me to read and I have found helpful:

The Over-Indulged Child: A Parent's Guide to Mentoring by James A. Fogarty -I found this book enlightening and it had some good ideas in it. Especially deciphering 'wants' versus 'needs'.

Setting Limits by Robert J. Mackenzie - This book has been extremely helpful with my difficult child. I have been able to identify my parenting style and revise it so that it works a bit better. I recommend reading them in this order after you've read The Explosive Child. Combined it seems to be working great for me.

I have a few more books she's given me that I am still getting through, and will post them if I find anything good in them.

. When Parents Hurt: Compassionate Strategies When You and Your Grown Child Don't Get Along by Dr. Joshua Coleman
offers insight, empathy, and perspective to those who have lost the opportunity to be the parent they desperately wanted to be and who are mourning the loss of a harmonious relationship with their child. Through case examples and healing exercises, Dr. Coleman helps parents: Reduce anger, guilt, and shame, Learn how temperament, the teen years, their own or a partner's mistakes, and divorce can strain the parent-child bond, Come to terms with their own and their child's imperfections, Develop strategies for rebuilding the relationship or move toward acceptance of what can't be changed, By helping parents recognize what they can do and let go of what they cannot, Dr. Coleman helps families develop more positive ways of healing
Candid Confessions of an Imperfect Parent: Building Relationships, Buying Breakfasts, and Other Secrets for Connecting with Your Teenagerby Jonathan McKee
Oh Boy, Oh Boy, Oh Boy: Confronting Motherhood, Womanhood & Selfhood in a Household of Boys by Karin Kasdin

The B itch in the House: 26 Women Tell the Truth About Sex, Solitude, Work, Motherhood, and Marriage by Cathi Hanauer Women today have more choices than at any time in history, yet many smart, ambitious, contemporary women are finding themselves angry, dissatisfied, stressed out. Why are they dissatisfied? And what do they really want? These questions form the premise of this passionate, provocative, funny, searingly honest collection of original essays in which twenty-six women writers invite readers into their lives, minds, and bedrooms to talk about the choices they've made, what's working, and what's not.

The Normal One: Life with a Difficult or Damaged Sibling by Jeanne Safer, PhD : In the first book of its kind, renowned psychotherapist Jeanne Safer examines the hidden trauma of growing up with an emotionally troubled or physically disabled sibling, and helps adult "normal" siblings resolve their childhood pain. So many of us have difficult child siblings - or worry about the effects our own difficult child is having on his/her siblings. Great insights.

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Recommended Book List | FAQ, Site Help, and Resources

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Recommended Book List * The following books are just a few of the most recommended by members of our board. Back in Control by Gregory Bodenhamer "Back in Control is based on a highly successful program that has helped thousands of parents regain control over their children. Without...

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Cognitive behavioral therapy (CBT) is a type of talk therapy that can help people of all ages, including younger children and teens. CBT focuses on how thoughts and emotions affect behavior. Your child doesn't need to have a diagnosed mental health condition to benefit from CBT.

Therapy usually involves an agreed upon goal and a set number of sessions. The therapist will help your child learn to replace negative thought patterns with more productive ones. Through role-playing and other methods, your child can practice alternate ways of handling stressful situations.

We'll explore what you need to know about CBT for kids, as well as how to find a qualified therapist.

CBT is a form of talk therapy designed to help people recognize unhelpful thoughts and behaviors and learn how to change them. Therapy focuses on the present and the future, rather than on the past.

While CBT isn't designed to "cure" conditions such as ADHD, it can be used to complement other therapies and to help improve specific symptoms.

CBT for kids has practical everyday applications. This therapy can help your child understand the negativity of their thought patterns and learn how to replace them with more positive ones. Discovering new ways of looking at things helps a child learn how to respond differently and improve rather than worsen stressful situations.

This type of therapy can give your child realistic strategies to improve their lives in the here and now. Once these strategies become habit, the new skills can follow them throughout their lives.

CBT can help children learn to control:

Replacing negative reactions with:

improved self-image

new coping mechanisms

problem-solving skills

more self-control

Usually, a parent or caregiver, the child, and a therapist will discuss goals and develop a treatment plan.

CBT involves a structured approach to solving problems in a specified number of sessions. It can be as few as six sessions or as many as 20 or more, depending on the child and the particular goals.

While CBT is a type of talk therapy, it's so much more than talk. The therapist will work to provide tangible ways for your child to take control and empower themselves. They will teach skills that can be put into practice immediately.

Your child can have CBT alone or in combination with medications or any other therapies they might need. The treatment plan can be adapted to meet cultural or regional differences.

CBT techniques

Play therapy. Arts and crafts, dolls and puppets, or role-playing are used to help the child address problems and work out solutions. This can also help keep younger children engaged.

Trauma-focused CBT. This method is used to treat children affected by traumatic events, including natural disasters. The therapist will focus on behavioral and cognitive issues directly related to trauma the child has experienced.

Modeling. The therapist may act out an example of the desired behavior, such as how to respond to a bully, and ask the child to do the same or to demonstrate other examples.

Restructuring. This technique is a way for a child to learn to take a negative thought process and flip it to a better one. For example, "I stink at soccer. I'm a total loser" can become "I'm not the best soccer player, but I'm good at a lot of other things."

Exposure. The therapist slowly exposes the child to the things that trigger anxiety.

Whatever the technique, CBT can be conducted a number of ways, such as:

Individual. Sessions involve only the child and the therapist.

Parent-child. The therapist works with the child and parents together, teaching specific parenting skills so their children make the most of CBT.

Family-based. Sessions can involve parents, siblings, or others who are close to the child.

Group. Includes the child, therapist, and other children who are dealing with the same or similar problems.

Your child doesn't have to have a diagnosed mental health condition to benefit from CBT. But it can be quite effective in dealing with specific conditions, such as:

Attention deficit hyperactivity disorder (ADHD)

Children with ADHD may have a hard time sitting still and may engage in impulsive behaviors. While there are medications to treat this disorder, sometimes they're not the first or only choice of treatment.

Even with medications, some children have persistent symptoms. Research shows that for some teens, adding CBT works better than medication alone.

Anxiety and mood disorders

CBT has been shown to be an effective treatment for children and adolescents with anxiety and mood disorders.

A 2015 review found "substantial support" for CBT as an effective first-line treatment for children with anxiety disorders.

Parents may have a role to play, too. A found that CBT with active parent involvement showed promise as an effective therapy for those ages 3 to 7 with anxiety. The study involved only 37 children, but they showed significant improvement in an average of 8.3 treatment sessions.

Anxiety with autism spectrum disorder

Many adolescents with high functioning autism spectrum disorder have anxiety. In a , a CBT program was designed for preteens with autism spectrum disorders plus clinical anxiety. The program focused on:

exposure

challenging irrational beliefs

behavioral support provided by caregivers

treatment elements specific to autism spectrum disorder

The small study involved only 33 children from 11 to 15 years old. Parents reported a positive effect of CBT on the severity of anxiety symptoms.

Trauma and PTSD

CBT is a first-line treatment for post-traumatic stress disorder (PTSD) in children and adolescents and has been shown to have short-term and long-term benefits.

A 2011 review found significant improvement at an 18-month follow-up and a 4-year follow-up. CBT has been found to be effective for acute and chronic PTSD after a range of traumatic experiences, even for young children.

CBT may also be helpful in treating:

Explaining the idea of CBT to younger children must be done in simple terms. To make things easier, some therapists use worksheets to help children visualize certain concepts.

For example, a worksheet may have drawings with blank thought bubbles for the child to fill out. The therapist may ask the child what the person in the picture is thinking about. Worksheets may include stop signs, to help the child recognize signs that they're about to lose control.

Worksheets can help children and adolescents understand how thoughts, feelings, and actions are connected. Through these worksheets, they can solidify what they've learned. CBT for children may also involve planners, checklists, or a rewards chart to help children remember and complete tasks.

CBT is an evidence-based practice shown to be effective for a variety of issues.

Meta-analyses show that up to of youth treated with CBT for anxiety disorders recover with significant decrease in symptoms following treatment. Follow-up studies of children treated in community mental health clinics show that those recovery rates are likely to continue at 4 years post-treatment.

Studies show that many adolescents with ADHD who received CBT had a significant reduction in symptom severity.

Among children with PTSD who receive individual trauma-focused CBT, there can be a great improvement of symptoms of PTSD, depression, and anxiety. In one , 92 percent of participants no longer met criteria for PTSD after CBT. This gain was still seen at a 6-month follow-up.

While there are many therapists trained in CBT, it's important to look for one who has experience working with children. Here are some things to look for:

Credentials. Look for a licensed counselor, family therapist, clinical social worker, psychologist, or psychiatrist. Licensure indicates a professional has met the legal standards to practice in your state.

Experience. Look for a professional who has worked with children or adolescents.

Transparency. Look for a professional willing to state goals and offer a treatment plan after an initial assessment or session with you and your child.

tips for finding a qualified mental health professional
Here are a few ways to locate mental health professionals with experience in CBT for kids:

Ask your family doctor or pediatrician for a referral to a qualified CBT specialist.

Call local universities, medical school psychiatry departments, or hospitals for referrals.

Ask family and friends who have used CBT.

Ask your insurance company for a list of qualified providers of CBT that are in-network or will be part of your coverage.

Visit these websites for lists of qualified professionals in your area:

CBT can help children understand how thoughts and emotions affect behavior and how changing their thoughts and emotions can change this behavior and the way they feel.

CBT is a safe, effective therapy that can help kids with a wide range of conditions and concerns.

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Cognitive Behavioral Therapy (CBT) for Kids: How It Works

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Cognitive behavioral therapy (CBT) is a type of talk therapy that can help people of all ages, including younger children and teens. CBT focuses on how thoughts and emotions affect behavior. Your child doesn't need to have a diagnosed mental health condition to benefit from CBT.

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You know you should be incorporating self-care. You know you can't pour from an empty cup. Sometimes it just takes hearing from others who get it. So Confident Counselors, what is your go to self care activity?

My two favorite self care activities are baking and napping. I love to bake for a couple of reasons. I am a hands-on person, so using my hands to make something is really gratifying for me. I also love that I can make a large batch of something that I can then share with a neighbor or coworker to build relationships.

Napping is so restorative for me too; I tend to let sleep suffer when I have a lot on my plate and am always reminded of the healing powers of sleep!
- Keri from Counselor Keri
Self-care is something that I need to work on. As many of us do, I often put other's needs before my own. Things I do to relax vary from writing to getting a manicure to baking or taking photographs of nature.

Paying it forward has also become a mode of self-care for me. A few times a year, when I treat myself to a purchase at Starbucks, I like to buy an extra something for the person behind me. Not only am I treating myself, but someone else too.
- The Sunny Sunshine Student Support Store
Counseling is a very analytic profession-between the communication, listening, and problem solving, our minds often need a break from thinking! One of my favorite self-care activities is painting because it allows my mind to think creatively. I love using watercolor or acrylic paint to create abstract designs or florals.

Another great escape that I have recently found is Pure Barre. It's a combination of ballet and pilates that is super challenging and allows my mind to focus on small, isometric movements to shape my body. Wondering how you can make more time in your life for self-care? Read my post about prioritizing your day to make more time for self-care.

My favorite self-care activity is a long hot bubble bath. I wrap up what I need to do for the day, put the baby to bed and start to fill the tub. I like to make myself a bowl of strawberries to snack on, climb in the tub and let the water wash my worries away. It is so calming to me and allows me private time to think and create a plan of action for the following days.

In addition to baths, I love to go to the gym after a long hard day. I like to lift heavy weights and leave all my stresses in the gym when I leave. I love the gym, but I have to admit that baths are definitely more fun.
- Mrs. Bell The Crafty Counselor
I really enjoy being outside with my animals. Nature is one of the easiest ways to recharge. We often take for granted the powerful benefits of the great outdoors and our furry friends. Research shows that pets play an important role in lowering stress levels. Additionally, vitamin D from the sun is essential for physical and mental health. I try to leave my phone in the house so that I'm not tempted to check my notifications. It's essential to unplug from social media for a period of time each day. If you aren't able to go outside that often, you can open the curtains, put down the phone, pet your fur babies and look outside more!
- The Counseling Teacher, Brandy What are your favorite self care activities?
Previous Self Care Posts

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Conversations: What is your go-to self-care activity?

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You know you should be incorporating self-care. You know you can't pour from an empty cup. Sometimes it just takes hearing from others who get it. So Confident Counselors, what is your go to self care activity? My two favorite self care activities are baking and napping.

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Getting Started with Remote Teaching and Learning

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When a child shows signs of anxiety, we tend to think it will go away-she's just nervous or shy, and she'll grow out of it. But when the anxiety becomes so intense that it's seriously interfering with a child's life, and the life of her family, it's important to get help.

Serious untreated anxiety tends to get worse over time, not better, because the child learns that avoidance works in reducing the anxiety, at least in the short run. But as the child-and, indeed, the whole family-work to avoid triggering those fears, they only grow more powerful.

Medication is often prescribed for children with anxiety, as it is for adults. And medication -antidepressants are usually our first choice-often helps reduce anxiety. But what many people don't know is that cognitive behavioral therapy (CBT) can be very effective for kids who are anxious. In fact, research over more than 20 years has shown that CBT is the most effective treatment for reducing symptoms of severe anxiety. And unlike taking medication, the therapy gives children the tools to manage the anxiety themselves, now and in the future.

What is cognitive behavioral therapy?

Cognitive behavioral therapy is based on the idea that how we think and act both affect how we feel. By changing thinking that is distorted, and behavior that is dysfunctional, we can change our emotions. With younger children, focusing first on the behavioral part of CBT can be most effective. The goal is, essentially, to unlearn avoidant behavior.

One of the most important techniques in CBT for children with anxiety is called exposure and response prevention. The basic idea is that kids are exposed to the things that trigger their anxiety in structured, incremental steps, and in a safe setting. As they become accustomed to each of the triggers in turn, the anxiety fades, and they are ready to take on increasingly powerful ones.

Exposure therapy is very different from traditional talk therapy, in which the patient and a therapist might explore the roots of the anxiety, in hopes of changing her behavior. In exposure therapy we try to change the behavior to get rid of the fear.

Exposure therapy is effective on many different kinds of anxiety, including separation anxiety, phobias, obsessive-compulsive disorder (OCD), and social anxiety.

The Bully in the Brain

For children with anxiety disorders, the process begins by helping them, and their parents, get some distance from the anxiety and start thinking of it as a thing that is separate from who they are. One way I do this is by having them conceptualize it as a "bully in the brain," and I encourage kids to give the bully a name and talk back to him. Kids I've worked with have called him the Witch, Mr. Bossy, Chucky, the Joker, and, in the case of some teenagers, names I cannot repeat here.

We explain that we are going to teach skills to handle the bully, giving children the idea that they can control their anxiety rather than it controlling them.

Related: What to Do (and Not Do) When Children Are Anxious

It's also important to help kids really understand how their anxiety is affecting their lives. I may actually map out things a child can't do because of his fears-like sleeping in his own bed, or going to a friend's house, or sharing meals with his own family-and how that makes him feel. Getting kids to understand how their anxiety works and gaining their trust is important because the next step-facing down their fears-depends on them trusting me.

Adopting Robert Frost's observation that "the only way around is through," exposure therapy slowly and systematically helps a child face his fears, so he can learn to tolerate his anxiety until it subsides rather than reacting by seeking reassurance, escaping, avoidance or engaging in ritualistic behaviors such as hand washing.

How does exposure therapy work?

The first step is identifying triggers. We design a "hierarchy of fears"-a series of incremental challenges, each of which is tolerable, and which together build to significant progress. Instead of thinking in black and white terms-I can't touch a dog or I can't cross a bridge-kids are asked to consider degrees of difficulty. We might ask a child with contamination fears, for example, "On a scale of 1 to 10, how difficult would it be to touch the door handle with one finger? To touch and open the door?"

Related: How Anxiety Leads to Disruptive Behavior

For a child with a fear of vomiting, we might ask: "How difficult would it be to write the word vomit?" If that is a 3, saying "I will vomit today" might be a 5. To see a cartoon of someone vomiting might rate a 7. To watch a real video of someone vomiting might be a 9. At the top of the hierarchy would likely be eating something the child thinks will make him vomit. By rating these different fears, kids come to see that some are less extreme, and more manageable, than they had thought.

Next, we expose the child to the trigger in its mildest possible form, and support him until the anxiety subsides. Fear, like any sensation, diminishes over time, and children gain a sense of mastery as they feel the anxiety wane.

Intensive treatment

With a child who is severely anxious-who can, for instance, barely leave his room for fear that his parents will die, or must wash his hands dozens of times a day to avoid contamination-I may work with him several times a week, for several hours at a time. We do exposures in the office and then, when a child is comfortable enough, do them outside.

For someone with social anxiety, for instance, we might go out wearing silly hats, or walk a banana on a leash. For someone afraid of contamination, we might ride the bus together, or shake hands with strangers, then eat chips without washing.

Once we have worked through some exposures and he is feeling more confident, I assign homework to practice what we did in the sessions. We want kids to really master their exposures before moving up the ladder. And parents are taught to help kids progress by encouraging them to tolerate anxious feelings, rather than jumping in to protect them from their anxiety.

Treatment for mild to moderate levels of severity usually takes eight to 12 sessions, and some kids make more progress if they are also taking medication to reduce their anxiety, which can make them more able to engage in therapy.

It's important to understand that exposure therapy is hard work, both for kids and their parents. But as fear diminishes, kids get back to doing things they like to do, and the family gets back a child they feared they had lost-and that's a great reward.

Read More:
Best Medications for Kids With Anxiety
Why Childhood Anxiety Often Goes Undetected (and the Consequences)

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Treating Anxiety in Children | Behavioral Treatment | Child Mind Institute

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When a child shows signs of anxiety, we tend to think it will go away-she's just nervous or shy, and she'll grow out of it. But when the anxiety becomes so intense that it's seriously interfering with a child's life, and the life of her family, it's important to get help.

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SPANISH Resources: Anxiety/Depression Assoc. of America

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SPANISH Resources: Anxiety/Depression Assoc. of America

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Fundada en 1979, ADAA es una organización internacional sin fines de lucro dedicada a la prevención, tratamiento y cura de la ansiedad, depresión, el trastorno obsesivo-compulsivo y trastornos relacionados con el trauma a través de la educación, la práctica y la investigación.

ADAA ofrece los siguientes recursos y servicios:

Encuentre un terapeuta cercano a usted que se especialice en el tratamiento de la ansiedad u otros trastornos relacionados.

El grupo anónimo de apoyo a la ansiedad y depresión en línea uno a uno de ADAA es un lugar amistoso, seguro y de apoyo para que las personas y sus familias compartan información y sus experiencias. Aprende más.

Inscríbase a nuestro boletín electrónico mensual gratuito, Triumph, para personas interesadas en aprender más sobre la ansiedad, la depresión, TOC, PTSD y enfermedades relacionadas, con el fin de tomar decisiones informadas sobre cómo obtener ayuda.

Videos Psicoeducativos Españoles/Spanish Psychoeducational Videos

Esta serie de videos presenta información acerca de síntomas que usted o alguien que usted conozca puede estar experimentando. Si tiene dudas acerca de alguna emoción, pensamiento, conducta o sensación en su cuerpo, estos videos le pueden ayudar a entender si podrían ser parte de una condición de salud mental. Estos videos no deben sustituir una evaluación clínica completa por un profesional de la salud mental, pero pueden ser utilizados para determinar si necesita una cita. Si quiere más información luego de ver los videos, en la página web de ADAA tenemos muchos recursos adicionales en español.
Haga clic aquí para ver más.
ADAA ha lanzado nuevos recursos para personas que hablan el español y profesionales que trabajan con la comunidad latina.

Descargar Gráficos:

Folletos ADAA

Seminarios Web

Podcasts
Publicaciones en Español
Videos

Libros

Otros Recursos

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Fundada en 1979, ADAA es una organización internacional sin fines de lucro dedicada a la prevención, tratamiento y cura de la ansiedad, depresión, el trastorno obsesivo-compulsivo y trastornos relacionados con el trauma a través de la educación, la práctica y la investigación. ADAA ofrece los siguientes recursos y servicios:

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Generalized Anxiety Disorder Simulation, Psychology Video Case Study

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Fight Flight Freeze – A Guide to Anxiety for Kids

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Anger Management for Kids: How can parents help kids learn to manage their anger? 10 ways parents can help kids calm down and recognize big emotions using these great visual tools - the emotion picture cards and calm down picture cards.

Helping Kids Handle Anger With

Asking and then expecting little kids to manage their big emotions is nearly impossible.

Why?

Well, even for adults, this is hard.

But for little kids, it's not something they're hard-wired to do.

Yet.

For kids who are still learning and developing each and every day, this isn't a skill-set they're born with, any more than they're born with the ability to tie their shoes.

With a little help from their parents and caregivers, it's a skill set that's taught through practice, patience and gaining emotional intelligence as they get bigger.

Turning big explosive emotions into an ant hill, instead of a volcano means kids need to be taught how to self-regulate and calm down, but like any new skill, it requires plenty of practice to learn how to express feelings appropriately, and safely.

Reactions to emotions are learned - from the child's environment at home (namely parents), other kids, at school and through media they've exposed to.

It's easy for children to become desensitized to violence and act out their anger when the movie they're watching exposes them to this.

However, they can also learn how to express themselves in calm and respectful ways from modeled behavior by parents, teachers, grandparents, relatives, and limitations to media.

Pssst... be sure to also download your Emotions Identification Chart for Kids down below.

More Reasons Why Children Express Anger:

1. Anger is typically a mask to other feelings a child is experiencing under the surface. You have to dig to see what caused the anger...

2. Anger is a disguise for sadness, hurt, fear, jealousy and other emotions. Look under the hood to see what comes up when your child feels like talking. Stay away from leading questions, instead let them steer you towards the emotion by describing their feelings.

3. Aggressive acts can be a child's developmental ways of exerting their independence and testing the limits of self-control.

Age-by-Age Guide to Emotional Self-Regulation

Age: Toddler, 1 - 2 Years Old

Child's Behavior: Taking what they want from others instead of asking or waiting for a turn

Adult Response: Remind your child they can't take without asking permission and must give the object back until the other person is done with it. Distract the child with another activity or toy. This is how children learn to get along and play with each other.

Age: Preschool, 3 - 5 Years Old

Child's Behavior: Hitting and/or biting strikes at this age as a form of asserting oneself

Adult Response: Using hands and acting aggressive towards others isn't acceptable behavior. Acknowledge your child's feelings but be firm that this behavior isn't allowed. Name the feelings and action, to bolster the child's emotional intelligence and understanding of the emotion at this age.

Age: School-Aged, 6 - 8 Years Old

Child's Behavior: Backtalk, not listening, door slamming and eye rolling.

Adult Response: Your child is beginning to assert their independence and opinions in unwelcome ways. It's time to give your child space to calm down by themselves before you reason with them or talk it out. Emotions run hot at this age and children are learning about self-control.

Once the dust has settled, name the emotions and behavior and ask the child for better solutions to their behavior so they can build a toolbox of appropriate and calm responses.

Anger Management for Kids: 10 Ways Parents Can Help Kids Calm Down

An even-tempered and calm, consistent response from the adults in the child's life will teach them how to react to everyday frustrations and challenges, without their first response being big, hard-to-handle explosive behavior.

If you're a calm parent, your child will learn how to calm their reactions as well.
Helpful Resources for Parents:
The best way to teach children how to handle their emotions - and especially anger - is to model it for them. You are the best example for your child when it comes to constructively handling behavior, reactions, and emotions in various circumstances.

Children learn by seeing and doing - not reading it in a book or being told how to act. Your example is what your children will emulate.
Helpful Resources for Children:
If a child's first reaction is to lash out when they feel upset and angry, parents first reaction should be to respond calmly and remind the child it's never OK to hurt others, or property. Then, this goes back to #1 and #2 above - find where your child has been modeled this behavior and work hard to change it.
Helpful Resources for Children:
The 3:10 calm down formula helps kids refocus their emotions and body for 30 seconds on something soothing to wipe away the anger and intense emotions and help their body come down from code red.
Here's how the 3:10 Calm Down Formula works:

Guide your child through this several times until they get the hang of it and can recognize the technique when you stop them and say, "let's do the 3:10 calm down trick for a second."

First, place one or both hands on the tummy and take three deep breaths, feeling the stomach expand as you inhale deeply and then slowly as you blow out the air slowly.

Next, have your child close their eyes and count to ten slowly. Once they reach ten, while keeping the eyes closed, take another deep breath and count backwards from 10 to 1. Open the eyes.

The best approach is to use the 3:10 approach before the child has lost control, and when they feel their body giving off warning signs it's buzzing from anger.

This is a very simple calm down technique but it gives children - and adults - time to slow their body down and redirect their focus from anger to relaxation.

Using this set of calm down cards to provide kids with solutions that will help them manage their emotions and cool off.

Create a calm down space in your home for any of your children to use when they want is a great way to let them be alone and calm down by themselves, or just as a getaway spot when they feel overstimulated, tired and want to be by themselves.

This helpful article will share more tips on creating a calm down spot in your home and what low sensory items do best to calm down children.

Young children express anger and other frustrations simply because they don't know how to express themselves in any other way other than with aggression.

Showing feelings with big displays such as hitting, tantrums, kicking, screaming and running away are typical responses for children who don't know how to communicate their feelings yet.

The first step is to teach emotional intelligence to a child by helping them connect the dots of emotions and behavior.

For example:

"You hit your sister because you are angry she took your toy without asking."

"I see you are sad and crying because your feelings got hurt when your friend didn't want to play."

"It looks like you're frustrated you can't untangle the rope and it makes you mad."

Acknowledging big feelings and tying them to a behavior helps children understand the range of emotions and in time, name them without an adult's help.

Asking your child to "tell me how you feel" when they don't know what feelings are, is unrealistic unless they've been taught.

Emotion picture cards are a simple tool to help kids identify emotions and build emotional intelligence.

Using emotion cards helps children not only learn about feelings, but recognize body language of others and their feelings as well.

Once kids learn to recognize their feelings, you can begin to have a conversation to help them find solutions and problem solve on their own.

Children are very visual learners - not only by what behavior their parents model for them, but also with pictures. Two valuable tools to teaching children how to recognize emotions is by using emotion cards and a poster of emotions with facial expressions.

Download Your Printable Emotions Identification Chart for Kids
These are valuable tools because:

Kids learn names for all the different emotions

They can recognize facial expression of others and read their emotions

Communicate through the visual cues even when they can't find the words to describe the emotion

Explaining to children that when we listen to our body, we'll hear warning signs about how we feel, especially when we are getting angry.

Learning to recognize these warning signs cues us into our feelings and when these warning signs show up, kids can learn to take calm down measures into their own hands and help them stay out of trouble.
Body Language Warning Signs:

Clenched fist

Grinding or clenched teeth

Fidgeting

Racing heart

Flushed cheeks

Bubbling in the Stomach

Breathing Faster

Teach kids to look for these warning signs before their anger is triggered and then they can dip into their calm down toolkit for anger management strategies to help them chill out.

Kids need opportunities to calm down, otherwise they may not know what to do how to stop bodies from going crazy. When they are used to getting in trouble and this is the only behavior they know, they'll keep getting in trouble but if they know how to make a better choice, they can learn to replace angry behavior with positive alternatives.

Not only due visual cards help kids learn and name their emotions, but they can offer helpful suggestions to calming down as well.

Here are is a great set of calm down cards - the download will be emailed to you as PDF printable files to print at home or take to your local print store.

If you'd rather not use calm down cards, create a list of calm down ideas for your child to look at and chose from when they need and keep it in a handy spot they can find on their own.

For example:

Ask for a hug

Go for a bike ride

Shoot baskets

Use the 3:1 Calm Down Formula

Put on headphones and listen to music

Work on a puzzle

Draw pictures

Drink a glass of cold water

Sing a song

Jump on a trampoline

Take a shower or bath

Walk away

Sometimes, children cannot solve a problem by themselves and need to ask an adult for help. Encourage them to reach out and ask you to support them through this wave of big emotions and help them find constructive solutions to deal with their anger.

Helping Kids Build Calm Down Habits to Deal with Angry Behavior

It's a research proven fact that building new habits and changing old behaviors takes at least 40 days of practice, not the 21 days we hear so often.

This means, to build these calm down skills and practice using the 3:1 Calm Down Formula successfully, parents need to encourage their kids every day for at least 3 weeks to practice them.

Practicing these new skills repetitively helps kids naturally build a stronger, more acceptable calm down toolbox and leads them to having more peaceful relationships and lives.

Need a little extra handling your child's big emotions? Here's a FREE Parenting Course to help you both turn things around.

Related Resources:

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Anger Management for Kids: 10 Ways to Help Kids Calm Down

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Anger Management for Kids: How can parents help kids learn to manage their anger? 10 ways parents can help kids calm down and recognize big emotions using these great visual tools - the emotion picture cards and calm down picture cards . Asking and then expecting little kids to manage their big emotions is nearly impossible.

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Centers for Disease Control and Prevention

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Children with attention-deficit/hyperactivity disorder (ADHD) experience more obstacles in their path to success than the average student. The symptoms of ADHD, such as inability to pay attention, difficulty sitting still, and difficulty controlling impulses, can make it hard for children with this diagnosis to do well in school.

To meet the needs of children with ADHD, schools may offer

ADHD treatments, such as behavioral classroom management or organizational training;

Special education services; or

Accommodations to lessen the effect of ADHD on their learning.

Classroom Treatment Strategies for ADHD Students

There are some school-based management strategies shown to be effective for ADHD students: behavioral classroom management and organizational training.

The behavioral classroom management approach encourages a student's positive behaviors in the classroom, through a reward systems or a daily report card, and discourages their negative behaviors. This teacher-led approach has been shown to influence student behavior in a constructive manner, increasing academic engagement. Although tested mostly in elementary schools, behavioral classroom management has been shown to work students of all ages.

Organizational training teaches children time management, planning skills, and ways to keep school materials organized in order to optimize student learning and reduce distractions. This management strategy has been tested with children and adolescents.

These two management strategies require trained staff-including teachers, counselors, or school psychologists-follow a specific plan to teach and support positive behavior.

The American Academy of Pediatrics (AAP) recommends that the school environment, program, or placement is a part of any ADHD treatment plan. AAP also recommends teacher-administered behavior therapy as a treatment for school-aged children with ADHD. You can talk to your child's healthcare provider and teachers about working together to support your child.

Special Education Services and Accommodations

Most children with ADHD receive some school services, such as special education services and accommodations. There are two laws that govern special services and accommodations for children with disabilities:

The Individuals with Disabilities Education Act (IDEA)

Section 504 of the Rehabilitation Act of 1973

The support a child with ADHD receives at school will depend on if they meet the eligibility requirements for one of two federal plans funded by IDEA and Section 504: an individualized education program (IEP) or a 504 Plan.

What are the main differences between the two Plans?

IEPs provide individualized special education services to meet the unique needs of the child.

A 504 Plan provides services and changes to the learning environment to meet the needs of the child as adequately as other students.
Learn more about IEP and 504 Plans [PDF - 2.75 MB]
Accommodations

IEP and 504 Plans can offer accommodations for students to help them manage their ADHD, including:

Extra time on tests;

Instruction and assignments tailored to the child;

Positive reinforcement and feedback;

Using technology to assist with tasks;

Allowing breaks or time to move around;

Changes to the environment to limit distraction; and

Extra help with staying organized.

There is limited information about which types of accommodations are effective for children with ADHD. However, there is evidence that setting clear expectations, providing immediate positive feedback, and communicating daily with parents through a daily report card can help.

What Teachers Can Do To Help

For teachers, helping children manage their ADHD symptoms can present a challenge. Most children with ADHD are not enrolled in special education classes, but do need extra assistance on a daily basis. The National Resource Center on ADHD provides information for teachers from experts on how to help students with ADHD.

Here are some tips for classroom success.

Communication

Give frequent feedback and attention to positive behavior;

Be sensitive to the influence of ADHD on emotions, such as self-esteem issues or difficulty regulating feelings;

Provide extra warnings before transitions and changes in routines; and

Understand that children with ADHD may become deeply absorbed in activities that interest them (hyper-focus) and may need extra assistance shifting their attention.

Assignments and Tasks

Make assignments clear-check with the student to see if they understand what they need to do;

Provide choices to show mastery (for example, let the student choose among written essay, oral report, online quiz, or hands-on project;

Make sure assignments are not long and repetitive. Shorter assignments that provide a little challenge without being too hard may work well;

Allow breaks-for children with ADHD, paying attention takes extra effort and can be very tiring;

Allow time to move and exercise;

Minimize distractions in the classroom; and

Use organizational tools, such as a homework folder, to limit the number of things the child has to track.

Develop a Plan That Fits the Child

Observe and talk with the student about what helps or distracts them (for example, fidget tools, limiting eye contact when listening, background music, or moving while learning can be beneficial or distracting depending on the child);

Communicate with parents on a regular basis; and

Involve the school counselor or psychologist.

Close collaboration between the school, parents, and healthcare providers will help ensure the child gets the right support.

Parent Education and Support

CDC funds the National Resource Center on ADHD (NRC), a program of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). The NRC provides resources, information, and advice for parents on how to help their child. Learn more about their services.

How to best advocate for your child

Understand your child's diagnosis, how it impacts their education, and what can be done at home to help.

Understand your child's IEP. If you have questions, don't be afraid to ask.

Speak with your child's teacher.

When possible, obtain written documentation from teachers, administrators, or other professionals working with your child.

Know your rights.

Play an active role in preparing your child's IEP or 504 Plan.

Keep careful records, including written documentation, communication between home and school, progress reports, and evaluations.

Try to maintain a good working relationship with the school while being a strong advocate for your child.

Communicate any concerns you may have about your child's progress or IEP or 504 Plan.

Encourage your child every day, and work with your child to create a system to help with homework and other school projects.

What every parent should know

More Information

Reference

1. Evans S, Owens J, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology 2014;43(4):527-551 [Read overview]

2. DuPaul GJ, Chronis-Tuscano A, Danielson ML, Visser SN. Predictors of receipt of school services in a national sample of youth with ADHD. Journal of Attention Disorders Published online December 10, 2018. [Read summary]

3. Harrison JR, Bunford N, Evans SW, Owens JS. Educational accommodations for students with behavioral challenges: A systematic review of the literature. Review of Educational Research 2013;83(4):551-97.

4. Moore DA, Russell AE, Matthews J, Ford TJ, Rogers M, Ukoumunne OC, et al. School-based interventions for attention-deficit/hyperactivity disorder: A systematic review with multiple synthesis methods. Review of Education. Published online October 18, 2018.

5. https://chadd.org/for-parents/individuals-with-disabilities-education-act/

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To meet the needs of children with ADHD, schools may offer ADHD treatments, special education services, or accommodations to lessen the effect of ADHD on their learning.

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Current and accurate as of January 2022
In Spanish | En español

The nation's special education law is called the Individuals with Disabilities Education Act, or IDEA. As part of making special education and related services available to children with disabilities in the public schools, Part B of IDEA defines the term "child with a disability." That definition includes specific disability terms, which are also defined by IDEA, as this webpage describes.

The IDEA's disability terms and definitions guide how States in their own turn define disability and who is eligible for a free appropriate public education under special education law. The definitions of these specific disability terms from the IDEA regulations are shown beneath each term listed below. Note, in order to fully meet the definition (and eligibility for special education and related services) as a "child with a disability," a child's educational performance must be adversely affected due to the disability.

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Quick-Jump Links

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In the list below, if a disability term is linked, clicking on the link will take you to a fact sheet for that particular disability and to other related information.
1. Autism...
...means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child's educational performance. Other characteristics often associated with autism are engaging in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term autism does not apply if the child's educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in #5 below.

A child who shows the characteristics of autism after age 3 could be diagnosed as having autism if the criteria above are satisfied.
2. Deaf-Blindness...
...means concomitant [simultaneous] hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children with blindness.

...means a hearing impairment so severe that a child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child's educational performance.

4. Developmental Delay...

...for children from birth to age three (under IDEA Part C) and children from ages three through nine (under IDEA Part B), the term developmental delay, as defined by each State, means a delay in one or more of the following areas: physical development; cognitive development; communication; social or emotional development; or adaptive [behavioral] development.
5. Emotional Disturbance...
...means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

(a) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(b) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(c) Inappropriate types of behavior or feelings under normal circumstances.

(d) A general pervasive mood of unhappiness or depression.

(e) A tendency to develop physical symptoms or fears associated with personal or school problems.

The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.
6. Hearing Impairment...
...means an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance but is not included under the definition of "deafness."
7. Intellectual Disability...
...means significantly subaverage general intellectual functioning, existing concurrently [at the same time] with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child's educational performance.

( Editor's Note, February 2011: "Intellectual Disability" is a new term in IDEA. Until October 2010, the law used the term "mental retardation." In October 2010, Rosa's Law was signed into law by President Obama. Rosa's Law changed the term to be used in future to "intellectual disability." The definition of the term itself did not change and is what has just been shown above.
8. Multiple Disabilities...
...means concomitant [simultaneous] impairments (such as intellectual disability-blindness, intellectual disability-orthopedic impairment, etc.), the combination of which causes such severe educational needs that they cannot be accommodated in a special education program solely for one of the impairments. The term does not include deaf-blindness.
9. Orthopedic Impairment...
...means a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g.,cerebral palsy, amputations, and fractures or burns that cause contractures).
10. Other Health Impairment...
...means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that-

(a) is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

(b) adversely affects a child's educational performance.
11. Specific Learning Disability...
...means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations. The term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. The term does not include learning problems that are primarily the result of visual, hearing, or motor disabilities; of intellectual disability; of emotional disturbance; or of environmental, cultural, or economic disadvantage.
12. Speech or Language Impairment...
...means a communication disorder such as stuttering, impaired articulation, a language impairment, or a voice impairment that adversely affects a child's educational performance.
13. Traumatic Brain Injury...
...means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech.

The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.
14. Visual Impairment Including Blindness...
...means an impairment in vision that, even with correction, adversely affects a child's educational performance. The term includes both partial sight and blindness.

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Considering the Meaning of "Adversely Affects"
You may have noticed that the phrase "adversely affects educational performance" appears in most of the disability definitions. This does not mean, however, that a child has to be failing in school to receive special education and related services. According to IDEA, states must make a free appropriate public education available to "any individual child with a disability who needs special education and related services, even if the child has not failed or been retained in a course or grade, and is advancing from grade to grade." [§300.101(c)(1)]

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**Highly Rated Resource! This resource was reviewed by 3-member panels of Parent Center staff working independently from one another to rate the quality, relevance, and usefulness of CPIR resources. This resource was found to be of "High Quality, High Relevance, High Usefulness" to Parent Centers.
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Categories of Disability Under Part B of IDEA

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Current and accurate as of January 2022 In Spanish | En español The nation's special education law is called the Individuals with Disabilities Education Act, or IDEA. As part of making special education and related services available to children with disabilities in the public schools, Part B of IDEA defines the term "child with a disability."

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Individuals with Disabilities Education Act

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Individuals with Disabilities Education Act (IDEA)

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The U.S. Department of Education’s Individuals with Disabilities Education Act website brings together department and grantee IDEA information and resources. The IDEA makes available a free appropriate public education to and ensures special education and related services to eligible children with disabilities.

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Council for Children with Behavioral Disorders

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Ask the Expert - Teens & Parents: Strategies to Reduce Conflict

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Voices: Living with Schizophrenia | WebMD

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https://tea.texas.gov/about-tea/other-services/mental-health/trauma-informed-grief-informed-practices

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Alternatives to Exclusionary Discipline

Exclusionary discipline policies, such as suspensions or expulsions, can have long-term negative consequences on youth (e.g. school dropout and involvement in the juvenile justice system) and school climate ( White House Report: The Continuing Need To Rethink Discipline; HHS and U.S. DoE Policy Statement on Exclusionary Discipline). Although federal data demonstrate steady declines in suspensions and expulsions, data indicate that students of color and students with disabilities continue to be disproportionately suspended or expelled.

Several states have addressed the negative consequences and disparities related to exclusionary discipline by enacting policies that direct schools and districts to eliminate or reduce punitive discipline practices and/or implement restorative practices.

Sources: Data retrieved via an extensive independent review by the NCSMH and supplemented by additional sources, including:

National Association of State Boards of Education (NASBE). (2020). State Policy Database: Alternatives to Exclusionary Discipline. Retrieved from: https://statepolicies.nasbe.org/health/categories/social-and-emotional-climate/alternatives-exclusionary-discipline

Education Commission of the States. (2018). School Discipline: Are there non-punitive approaches outlined as alternatives to suspension or expulsion? Retrieved from: http://ecs.force.com/mbdata/MBQuest2RTanw?rep=SD1804

All 50 states and the District of Columbia have either anti-bullying laws, regulations, model policies, or a combination of all three. These require districts to engage in bullying prevention and to respond when bullying occurs. Although it is necessary to address bullying, there is concern regarding the reliance on punitive responses to bullying. Punitive discipline practices do not reduce incidents of bullying and do not address harm.

The links in the map lead to state pages on stopbullying.gov, a site hosted by the US Department of Health and Human Services. In addition to describing the laws, policies, and common components, each state page provides link to the policy itself.

The information in the map was originally collected and compiled by several federal government agencies, including U.S. Department of Education (DoE), Department of Health and Human Services (HHS), and Department of Justice (DOJ).

U.S. Department of Health and Human Services. (2018). Laws, Policies, & Regulations | StopBullying.gov. https://www.stopbullying.gov/resources/laws

Culturally Responsive Teaching

Students, their families, and their communities thrive when school staff celebrate and integrate the societal contributions of people from different cultures in the classroom. According to the National Childhood Traumatic Stress Network (NCTSN), multicultural recognition in education increases personal meaning of classroom content, elevates student-teacher relationships, improves academic success, and enhances students' sense of belonging at school. Recognizing and honoring the experiences of diverse people reduces disenfranchisement among communities that are marginalized. The New America's report on culturally responsive teaching (CRT) notes that "the majority of states do not yet provide a description of CRT that is clear or comprehensive enough to support teachers in developing and strengthening their CRT practice throughout their careers." The map below provides access to state professional teaching standards that incorporate aspects of CRT.

The information in this map was originally compiled New America.

Muñiz, J. Culturally responsive teaching: A 50-state survey of teaching standards. New America. https://www.newamerica.org/education-policy/reports/culturally-responsive-teaching/

Every Student Succeeds Act (Chronic Absenteeism and School Climate)

One of the most significant components of the Every Student Succeeds Act (ESSA) is the requirement that states include multiple measures in their accountability systems. In addition to academic indicators (academic achievement, academic growth, graduation rate, and progress in achieving English language proficiency (ELP)), states must select at least one indicator of "school quality or student success" such as:

Rates of chronic absenteeism

College and career readiness

Student or educator engagement

Student access to and completion of advanced coursework

School climate

States have the flexibility to select multiple "school quality or student success" indicators and to use multiple measures within each indicator.

Expanded Medicaid Coverage in Schools

In 2014, the Center for Medicare and Medicaid Services (CMS) reversed the Free Care Rule, which restricted schools from getting reimbursement for services provided to Medicaid-enrolled students without an Individualized Education Plan (IEP). The reversal permits states to allow school districts to bill Medicaid for school-based health services, including mental health services, provided to all Medicaid-enrolled children, not just those with an IEP. To expand this eligibility, states need to take action, typically through modification of state Medicaid plans. For more information on school Medicaid, please visit the Healthy Students, Promising Futures webpage, a Healthy Schools Campaign program.

The map below displays states that have leveraged the policy reversal by expanding Medicaid coverage in schools, states that are in the process, and states that have not yet taken action.

This information was originally compiled by the Healthy Schools Campaign through their Healthy Students, Promising Futures program.

Partnering with and effectively engaging families is critical to the success of comprehensive school mental health systems. The map below displays states that have a policy directing districts to develop or implement plans, policies, or programs related to family engagement in schools.

The information in this map was compiled by the National Association of State Boards of Education.

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SHAPE - School Health Assessment and Performance Evaluation

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Alternatives to Exclusionary Discipline Exclusionary discipline policies, such as suspensions or expulsions, can have long-term negative consequences on youth (e.g. school dropout and involvement in the juvenile justice system) and school climate ( White House Report: The Continuing Need To Rethink Discipline; HHS and U.S. DoE Policy Statement on Exclusionary Discipline).

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The Texas Education Agency (TEA) continues to work with the Office of the Governor, Texas Department of State Health Services (DSHS) and the Texas Division of Emergency Management (TDEM) to coordinate and plan the state's response to COVID-19. TEA's role in these efforts is to help coordinate the flow of information from the state to districts, help districts solve problems, and provide guidance that will aid in districts' decision-making. TEA does not have the general authority to close schools for matters related to health.

General Public Health Resources

As DSHS is the lead agency in the state's preparedness efforts, school districts should be working closely with your local health authorities as you weigh operational decisions. You can find your local public health organization on the Department of State Health Services (DSHS) website. To see the status of COVID-19 cases, please visit the Department of State Health Services dashboard. If you think you need to be tested for COVID-19, this website allows Texans to find the nearest test collection site.

The Texas Health and Human Services Commission (HHSC) launched a statewide mental health support line to help all Texans experiencing anxiety, stress, or other emotional challenges due to the COVID-19 pandemic. Harris Center for Mental Health and IDD operates the line, which is available anytime day or night, at 833-986-1919. Counseling services are confidential and free of charge. More information on mental health resources and your local mental health authority can be found on HHSC's Website.

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Coronavirus (COVID-19) Support and Guidance

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The Texas Education Agency (TEA) continues to work with the Office of the Governor, Texas Department of State Health Services (DSHS) and the Texas Division of Emergency Management (TDEM) to coordinate and plan the state's response to COVID-19.

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Working to deliver a better special education service

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What is conduct disorder in children?

Conduct disorder is a type of behavior disorder. It's when a child has antisocial behavior. He or she may disregard basic social standards and rules. He or she may also:

Be irresponsible

Skip school or run away (delinquent behavior)

Steal or do other things to violate the rights of others

Physically harm animals or other people, such as committing assault or rape

These behaviors sometimes happen together. But one or more may occur without the others.

What causes conduct disorder in a child?

Experts believe that many factors play a role in conduct disorder. These are:

Brain damage

A traumatic event

Genes

Child abuse

Past school failure

Social problems

Some children with conduct disorders seem to have a problem in the frontal lobe of the brain. This interferes with a child's ability to plan, stay away from harm, and learn from negative experiences.

Some experts believe that a series of traumatic experiences occurs for a child to develop a conduct disorder. These experiences then often lead to depressed mood, behavior problems, and involvement in a deviant peer group.

Which children are at risk for conduct disorder?

A conduct disorder is more common in boys than in girls. It is also more likely to develop in children or teens who come from homes that are:

Children with these mental health problems are also more likely to have conduct disorder:

Children or teens who are considered to have a difficult temperament are more likely to develop behavior problems.

What are the symptoms of conduct disorder in a child?

Most symptoms seen in children with conduct disorder also happen at times in children without this problem. But in children with the disorder, these symptoms occur more often. They also interfere with learning, school adjustment, and sometimes with the child's relationships.

Each child's symptoms may vary. But the 4 main groups of behaviors are:

Aggressive conduct

Intimidating behavior

Bullying

Physical fights

Cruelty to others or animals

Using a weapon

Forcing someone into sexual activity, rape, or molestation

Destructive conduct

Intentionally destroying property (vandalism)

Arson

Deceitfulness

Violation of rules or age-appropriate norms

These symptoms may look like other mental health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is conduct disorder diagnosed in a child?

A child psychiatrist or qualified mental health expert can diagnose a conduct disorder. He or she will talk with parents and teachers about the child's behavior and may observe the child. In some cases, your child may need mental health testing.

If you notice symptoms of conduct disorder in your child or teen, you can help by seeking a diagnosis right away. Early treatment can often prevent future problems.

How is conduct disorder treated in a child?

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for conduct disorder may include:

Cognitive-behavioral therapy. A child learns how to better solve problems, communicate, and handle stress. He or she also learns how to control impulses and anger.

Family therapy. This therapy helps make changes in the family. It improves communication skills and family interactions.

Peer group therapy. A child develops better social and interpersonal skills.

Medicines. These are not often used to treat conduct disorder. But a child may need them for other symptoms or disorders, such as ADHD.

How can I help prevent conduct disorder in my child?

Experts don't know exactly why some children develop conduct disorder. Things such as a traumatic experience, social problems, and biological factors may be involved. To reduce the risk for this disorder, parents can learn positive parenting strategies. This can help to create a closer parent-child relationship. It can also create a safe and stable home life for the child.

How can I help my child live with conduct disorder?

Early treatment for your child can often prevent future problems. Here are things you can do to help your child:

When should I call my child's healthcare provider?

Call your healthcare provider right away if your child:

Feels extreme depression, fear, anxiety, or anger toward him or herself or others

Feels out of control

Hears voices that others don't hear

Sees things that others don't see

Can't sleep or eat for 3 days in a row

Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call 911 if your child has suicidal thoughts, a suicide plan, and the means to carry out the plan.
Key points about conduct disorder in children

Next steps

Tips to help you get the most from a visit to your child's healthcare provider:

Know the reason for the visit and what you want to happen.

Before your visit, write down questions you want answered.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Ask if your child's condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child's provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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Conduct disorder is a type of behavior disorder. It's when a child has antisocial behavior. He or she may disregard basic social standards and rules. He or she may also: Be irresponsible Skip school or run away (delinquent behavior) Steal or do other things to violate the rights of others Physically harm animals or other people, such as committing assault or rape These behaviors sometimes happen together.

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Conduct disorder is a group of behavioral and emotional problems that usually begins during childhood or adolescence. Children and adolescents with the disorder have a difficult time following rules and behaving in a socially acceptable way. They may display aggressive, destructive, and deceitful behaviors that can violate the rights of others. Adults and other children may perceive them as "bad" or delinquent, rather than as having a mental illness.

If your child has conduct disorder, they may appear tough and confident. In reality, however, children who have conduct disorder are often insecure and inaccurately believe that people are being aggressive or threatening toward them.

There are three types of conduct disorder. They're categorized according to the age at which symptoms of the disorder first occur:

Childhood onset occurs when the signs of conduct disorder appear before age 10.

Adolescent onset occurs when the signs of conduct disorder appear during the teenage years.

Unspecified onset means the age at which conduct disorder first occurs is unknown.

Some children will be diagnosed with conduct disorder with limited prosocial emotions. Children with this specific type of conduct disorder are often described as callous and unemotional.

Children who have conduct disorder are often hard to control and unwilling to follow rules. They act impulsively without considering the consequences of their actions. They also don't take other people's feelings into consideration. Your child may have conduct disorder if they persistently display one or more of the following behaviors:

aggressive conduct

deceitful behavior

destructive behavior

violation of rules

Aggressive Conduct

Aggressive conduct may include:

intimidating or bullying others

physically harming people or animals on purpose

committing rape

using a weapon

Deceitful Behavior

Deceitful behavior may include:

Destructive Behavior

Destructive conduct may include arson and other intentional destruction of property.

Violation of Rules

Violation of rules may include:

skipping school

running away from home

drug and alcohol use

sexual behavior at a very young age

Boys who have conduct disorder are more likely to display aggressive and destructive behavior than girls. Girls are more prone to deceitful and rule-violating behavior.

Additionally, the symptoms of conduct disorder can be mild, moderate, or severe:

Mild

If your child has mild symptoms, it means they display little to no behavior problems in excess of those required to make the diagnosis. Conduct problems cause relatively minor harm to others. Common issues include lying, truancy, and staying out after dark without parental permission.

Moderate

Your child has moderate symptoms if they display numerous behavior problems. These conduct problems may have a mild to severe impact on others. The problems may include vandalism and stealing.

Severe

Your child ha severe symptoms if they display behavior problems in excess of those required to make the diagnosis. These conduct problems cause considerable harm to others. The problems may include rape, use of a weapon, or breaking and entering.

Genetic and environmental factors may contribute to the development of conduct disorder.

Genetic Causes

Damage to the frontal lobe of the brain has been linked to conduct disorder. The frontal lobe is the part of your brain that regulates important cognitive skills, such as problem-solving, memory, and emotional expression. It's also home to your personality. The frontal lobe in a person with conduct disorder may not work properly, which can cause, among other things:

a lack of impulse control

a reduced ability to plan future actions

a decreased ability to learn from past negative experiences

The impairment of the frontal lobe may be genetic, or inherited, or it may be caused by brain damage due to an injury. A child may also inherit personality traits that are commonly seen in conduct disorder.

Environmental Factors

The environmental factors that are associated with conduct disorder include:

child abuse

a dysfunctional family

parents who abuse drugs or alcohol

poverty

The following factors may increase your child's risk of developing conduct disorder:

being male

living in an urban environment

living in poverty

having a family history of conduct disorder

having a family history of mental illness

having other psychiatric disorders

having parents who abuse drugs or alcohol

having a dysfunctional home environment

having a history of experiencing traumatic events

being abused or neglected

If your child is showing signs of conduct disorder, they should be evaluated by a mental health professional. They'll ask you and your child questions about their behavioral patterns to make a diagnosis. For a conduct disorder diagnosis to be made, your child must have a pattern of displaying at least three behaviors that are common to conduct disorder. Your child must also have shown at least one of the behaviors within the past six months. The behavioral problems must also significantly impair your child socially or at school.

Children with conduct disorder who are living in abusive homes may be placed into other homes. If abuse isn't present, your child's mental healthcare provider will use behavior therapy or talk therapy to help your child learn how to express or control their emotions appropriately. The mental healthcare provider will also teach you how to manage your child's behavior. If your child has another mental health disorder, such as depression or ADHD, the mental healthcare provider may prescribe medications to treat that condition as well.

Since it takes time to establish new attitudes and behavior patterns, children with conduct disorder usually require long-term treatment. However, early treatment may slow the progression of the disorder or reduce the severity of negative behaviors.

The long-term outlook for conduct disorder depends on the severity and frequency of your child's behavioral and emotional problems. Children who continuously display extremely aggressive, deceitful, or destructive behavior tend to have a poorer outlook. The outlook is also worse if other mental illnesses are present. However, getting a prompt diagnosis and receiving comprehensive treatment can significantly improve your child's outlook. Once treatment is received for conduct disorder and any other underlying conditions, your child has a much better chance of considerable improvement and hope for a more successful future.

Without treatment, your child is likely to have ongoing problems. They may be unable to adapt to the demands of adulthood, which can cause them to have problems with relationships and holding a job. They're also at an increased risk for substance abuse and problems with law enforcement. Your child may even develop a personality disorder, such as antisocial personality disorder, when they reach adulthood. This is why early diagnosis and treatment are critical. The earlier your child receives treatment, the better their outlook for the future will be.

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Conduct Disorder: Types, Causes, and Symptoms

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Conduct disorder is a group of behavioral and emotional problems that usually begins during childhood or adolescence. Children and adolescents with the disorder have a difficult time following rules and behaving in a socially acceptable way. They may display aggressive, destructive, and deceitful behaviors that can violate the rights of others.